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Individual

BRENDAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2865 N REYNOLDS RD STE 110, TOLEDO, OH 43615-2069
(419) 578-7530
(419) 539-0288
Mailing address
5901 BROWN LN, SYLVANIA, OH 43560-4501

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-10683
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000351928
ANTHEM PROVIDER NUMBER
OH
Enumeration date
02/20/2007
Last updated
07/08/2007
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