Individual
MR. CHARLES LARUE SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
77 MADISON AVE, MORRISTOWN, NJ 07960-7330
(973) 540-9800
Mailing address
55 VILLAGE GRN APT L, BUDD LAKE, NJ 07828-1355
(917) 613-8338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00976600
NJ
225100000X
Physical Therapist
PT-01355L
PA
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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