Provider Demographics
NPI:1174820427
Name:CANTY-SMITH, ALGA
Entity Type:Individual
Prefix:
First Name:ALGA
Middle Name:
Last Name:CANTY-SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 MATINEE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0417
Mailing Address - Country:US
Mailing Address - Phone:702-439-0941
Mailing Address - Fax:
Practice Address - Street 1:4419 MATINEE AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0417
Practice Address - Country:US
Practice Address - Phone:702-439-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner