Provider Demographics
NPI:1962506071
Name:SMITH, FRANCIS J JR (PT)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:J
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:29525 CANWOOD STREET # 113
Mailing Address - Street 2:
Mailing Address - City:AQOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4230
Mailing Address - Country:US
Mailing Address - Phone:818-707-2182
Mailing Address - Fax:818-707-4236
Practice Address - Street 1:29525 CANWOOD STREET # 113
Practice Address - Street 2:
Practice Address - City:AQOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4230
Practice Address - Country:US
Practice Address - Phone:818-707-2182
Practice Address - Fax:818-707-4236
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 9134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFSPT9134Medicare ID - Type Unspecified