Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | MI |
NPI | 1003424904 |
---|---|
Provider Name | Erin Smith |
First Address | Bay City, MI 48706-9299 |
Second Address | Bay City, MI 48706-9299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2020 |
Last Update Date | 16/07/2020 |