Provider Demographics
NPI:1508972126
Name:SMITH, JR., EDDISON J (RKT)
Entity Type:Individual
Prefix:MR
First Name:EDDISON
Middle Name:J
Last Name:SMITH, JR.
Suffix:
Gender:M
Credentials:RKT
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Mailing Address - Street 1:1 FREEDOM WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6258
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-793-9977
Practice Address - Street 1:2010 TEAL CT
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-7998
Practice Address - Country:US
Practice Address - Phone:706-793-3398
Practice Address - Fax:706-793-9977
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist