Provider Demographics
NPI:1003144130
Name:SMITH THERAPY SERVICES
Entity Type:Organization
Organization Name:SMITH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:864-286-8288
Mailing Address - Street 1:9 MAPLE TREE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4070
Mailing Address - Country:US
Mailing Address - Phone:864-286-8288
Mailing Address - Fax:864-286-8289
Practice Address - Street 1:100 WILLOW LN
Practice Address - Street 2:SUITE B
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1365
Practice Address - Country:US
Practice Address - Phone:864-573-2688
Practice Address - Fax:864-573-2587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6736Medicare PIN