Individual
SHIZUKA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
77 NEALY AVE, HAMPTON, VA 23665-2040
(757) 764-6963
Mailing address
112 BLACKBERRY BND, YORKTOWN, VA 23693-4538
(757) 764-6963
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2391
MT
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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