Provider Demographics
NPI:1932111705
Name:SMITH-FOUT, BARBARA A (PT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:SMITH-FOUT
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 1:1377 11TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5068
Mailing Address - Country:US
Mailing Address - Phone:563-241-4230
Mailing Address - Fax:563-519-4235
Practice Address - Street 1:1377 11TH ST NW
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5068
Practice Address - Country:US
Practice Address - Phone:563-241-4230
Practice Address - Fax:563-519-4235
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02010225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA41304OtherBLUE CROSS BLUE SHIELD IA
IA0665711Medicaid
IA41304OtherBLUE CROSS BLUE SHIELD IA
IAI7432Medicare PIN