Organization
SMITH & PROTHERO PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM CHARLES SMITH PT (MEMBER)
(410) 939-2262
Entity
Organization
Contact information
Practice address
807A S UNION AVE, HAVRE DE GRACE, MD 21078-3610
(410) 939-2262
(410) 939-7119
Mailing address
807A S UNION AVE, HAVRE DE GRACE, MD 21078-3610
(410) 939-2262
(410) 939-7119
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5874017-00
—
MD
01
—
CB2775
RAILROAD MEDICARE
MD
01
—
LS73SM
CAREFIRST BC/BS
MD
Enumeration date
07/26/2005
Last updated
10/09/2020
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