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Individual

HELEN R SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA, PTA

Contact information

Practice address
117 HAIDA DR, KENAI, AK 99611-7953
(907) 252-0594
Mailing address
100 TRADING BAY RD, SUITE 8, KENAI, AK 99611-7786
(907) 252-0594

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1582
AK
225700000X
Massage Therapist
101226
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101226
ALASKA STATE MASSAGE THERAPY BOARD
AK
01
1582
ALASKA STATE PHYSICAL THERAPY BOARD
AK
05
PTA008 1029862
AK
Enumeration date
10/21/2008
Last updated
05/19/2020
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