Provider Demographics
NPI:1376760744
Name:SMITHBERGER, KATHY MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:MARIE
Last Name:SMITHBERGER
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 1:5588 FLEETWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1442
Mailing Address - Country:US
Mailing Address - Phone:330-497-8097
Mailing Address - Fax:330-430-6972
Practice Address - Street 1:1320 MERCY DR NW
Practice Address - Street 2:PHYSICAL THERAPY DEPT
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2614
Practice Address - Country:US
Practice Address - Phone:330-489-1135
Practice Address - Fax:330-430-6972
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH054464225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist