Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 21748 | MA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 038865 | NY |
NPI | 1093190555 |
---|---|
Provider Name | Mrs. Erin Kimberly Smith I |
First Address | Boston, MA 02210-1941 |
Second Address | West Coxsackie, NY 12192 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2015 |
Last Update Date | 27/07/2015 |