Individual
AMANDA L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
516 GARDEN WAY, EDGEWOOD, KY 41017-3387
(941) 894-2956
Mailing address
516 GARDEN WAY, EDGEWOOD, KY 41017-3387
(941) 894-2956
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007495
KY
225100000X
Physical Therapist
PT23094
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AE321Z
MEDICARE ID TYPE
FL
Enumeration date
01/02/2007
Last updated
12/29/2021
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