| NPI | 1427173913 |
|---|---|
| Former Name | TRACY SMITH |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: WV 001364) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: PA TEE007620) |
| 225200000X Physical Therapy Assistant (Licence: NC A4675) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-11-28 |