Provider Demographics
NPI:1740575588
Name:SMITH, JOHN F (LMT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SMITH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3185 BABCOCK BLVD
Mailing Address - Street 2:P O BOX 101451
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2727
Mailing Address - Country:US
Mailing Address - Phone:412-480-0725
Mailing Address - Fax:412-937-4701
Practice Address - Street 1:3185 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2727
Practice Address - Country:US
Practice Address - Phone:412-480-0725
Practice Address - Fax:412-937-4701
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG000826225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist