Provider Demographics
NPI:1477736502
Name:SMITH, HEIDI JEAN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11110 MEDICAL CAMPUS RD
Mailing Address - Street 2:201
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6700
Mailing Address - Country:US
Mailing Address - Phone:301-714-4025
Mailing Address - Fax:301-714-4026
Practice Address - Street 1:11110 MEDICAL CAMPUS RD
Practice Address - Street 2:201
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6700
Practice Address - Country:US
Practice Address - Phone:301-714-4025
Practice Address - Fax:301-714-4026
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2023-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD223072251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic