Individual
MRS. ANDREA C SMISKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2400 W MALLARD CREEK CHURCH RD, CHARLOTTE, NC 28262-2324
(704) 323-2090
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P18974
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
397730041
NSC #
NC
Enumeration date
11/02/2011
Last updated
10/19/2021
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