Individual
MARY MARGARET SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4530 E MUIRWOOD DR STE 110, PHOENIX, AZ 85048
(480) 759-5808
(480) 759-0647
Mailing address
2910 N 3RD AVE, PHOENIX, AZ 85013-4434
(602) 406-3008
(602) 406-6108
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-007137
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068163
AHCCCS ID NO
AZ
Enumeration date
01/23/2007
Last updated
08/30/2018
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