Provider Demographics
NPI:1942515176
Name:SMOYER, ERIC C (PT, DPT, ATC, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:SMOYER
Suffix:
Gender:M
Credentials:PT, DPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 S 144TH ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5243
Mailing Address - Country:US
Mailing Address - Phone:402-609-1750
Mailing Address - Fax:
Practice Address - Street 1:2725 S 144TH ST
Practice Address - Street 2:SUITE 218
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5243
Practice Address - Country:US
Practice Address - Phone:402-609-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5372255A2300X
MN225100000X
NE34632251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic