Organization
WORKSAFE, PC
Active
Other names
Therapy Source
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HULET SMITH JR. OTR/L (OWNER/OCCUPATIONAL THERAPIST)
(770) 725-9186
Entity
Organization
Contact information
Practice address
1367 SYDNEYS PASS, WATKINSVILLE, GA 30677-8393
(770) 725-9186
(603) 843-2144
Mailing address
1367 SYDNEYS PASS, WATKINSVILLE, GA 30677-8393
(770) 725-9186
(603) 843-2144
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT006029
GA
225X00000X
Occupational Therapist
Primary
OT002264
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000823237A
—
GA
01
—
1609941913
INDIVIDUAL NPI
GA
01
—
1659446979
INDIVIDUAL NPI
—
Enumeration date
10/21/2009
Last updated
11/30/2010
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