Individual
MRS. CHRISTINA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5131 WILLOW BROOK DR, FORT WAYNE, IN 46835-1578
(260) 450-8581
(260) 492-1674
Mailing address
5131 WILLOW BROOK DR, FORT WAYNE, IN 46835-1578
(260) 450-8581
(260) 492-1674
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002763A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1555-656
—
IN
Enumeration date
07/02/2007
Last updated
07/08/2007
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