Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | OT010148 | OH |
NPI | 1013544022 |
---|---|
Provider Name | Bryce Carsone Smith |
First Address | Cleveland, OH 44109-4512 |
Second Address | Rocky River, OH 44116-4144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2020 |
Last Update Date | 27/03/2020 |