| NPI | 1275365587 |
|---|---|
| Former Name | STEPHANIE LYNNE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NC P23591) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP033228T) |
| 225100000X Physical Therapist (Licence: TN 14481) | |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-09-26 |