Provider Demographics
NPI:1417366311
Name:SMOOT, EMILY KATHERINE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHERINE
Last Name:SMOOT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:HERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 RIVER BLUFF WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-3646
Mailing Address - Country:US
Mailing Address - Phone:864-593-0918
Mailing Address - Fax:
Practice Address - Street 1:206 RIVER BLUFF WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-3646
Practice Address - Country:US
Practice Address - Phone:864-593-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist