Organization
VIDA BELLA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRISTINA REYES SMITH OTD, OTR/L (OWNER/OPERATOR)
(843) 814-7917
Entity
Organization
Contact information
Practice address
1303 WINDOVER RUN, HANAHAN, SC 29410-8219
(843) 814-7917
Mailing address
1303 WINDOVER RUN, HANAHAN, SC 29410-8219
(843) 814-7917
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3232
SC
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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