Individual
ANNA B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3054 ENTERPRISE DR, STATE COLLEGE, PA 16801-2755
(814) 234-6023
(814) 234-1439
Mailing address
3054 ENTERPRISE DR, STATE COLLEGE, PA 16801-2755
(814) 234-6023
(814) 234-1439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT019699
PA
2251P0200X
Pediatric Physical Therapist
PT019699
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT019699
LICENSE #
PA
Enumeration date
04/14/2009
Last updated
07/06/2015
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