Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1146531 | TX |
NPI | 1023025483 |
---|---|
Provider Name | Farrah E Smith |
First Address | Mansfield, TX 76063-3475 |
Second Address | Grand Prairie, TX 75052-6644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 22/06/2014 |