Provider Demographics
NPI:1407338486
Name:SMITH, ABBY (PT)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
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 1:26367 CONIFER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-9137
Mailing Address - Country:US
Mailing Address - Phone:303-838-3900
Mailing Address - Fax:303-838-4047
Practice Address - Street 1:26367 CONIFER RD STE A
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-9137
Practice Address - Country:US
Practice Address - Phone:303-838-3900
Practice Address - Fax:303-838-4047
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist