Provider Demographics
NPI:1366688939
Name:SMITH, CLAIRE E (PT)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 WATERWHEEL SQ
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2608
Mailing Address - Country:US
Mailing Address - Phone:443-858-8947
Mailing Address - Fax:410-521-4904
Practice Address - Street 1:3655 WATERWHEEL SQ
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2608
Practice Address - Country:US
Practice Address - Phone:443-858-8947
Practice Address - Fax:410-521-4904
Is Sole Proprietor?:No
Enumeration Date:2009-01-01
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist