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Individual

MRS. LISA G SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
1323 STRATFORD RD SE, SUITE B, DECATUR, AL 35601-6017
(256) 350-4182
Mailing address
1323 STRATFORD RD SE, SUITE B, DECATUR, AL 35601-6017
(256) 350-4182
(256) 309-5908

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH498
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51503968
BCBS
AL
Enumeration date
02/23/2006
Last updated
07/08/2007
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