Individual
HEATHER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9604 57TH AVE APT 15H, CORONA, NY 11368-3419
(718) 640-4682
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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