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Individual

MISS BARBARA ANN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
130 HOWARD LN, FAYETTEVILLE, GA 30215-1849
(770) 460-0165
Mailing address
1806 PORTWEST WAY, HAMPTON, GA 30228-3272

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001417
GA
2251P0200X
Pediatric Physical Therapist
PT001417
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000826636B
GA
Enumeration date
03/15/2007
Last updated
03/24/2021
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