Individual
BERYL ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1 CHILDRENS PLAZA, ORTHOPAEDIC CENTER FOR SPINAL & PEDIATRIC CARE, DAYTON, OH 45404-1815
(937) 641-3010
(937) 641-5003
Mailing address
2031 VIENNA PKWY, DAYTON, OH 45459-1356
(937) 439-1868
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2896324
TN
225100000X
Physical Therapist
PT-10782
OH
2251P0200X
Pediatric Physical Therapist
2896324
TN
2251P0200X
Pediatric Physical Therapist
PT-10782
OH
2251X0800X
Orthopedic Physical Therapist
2896324
TN
2251X0800X
Orthopedic Physical Therapist
Primary
PT-10782
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000330619
ANTHEM BCBS
OH
01
—
2487492
BCMH
OH
05
—
2487492
—
OH
Enumeration date
01/31/2006
Last updated
02/12/2009
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