Provider Demographics
NPI:1023297827
Name:SMYTH, RAYNE GENE (PT)
Entity type:Individual
Prefix:
First Name:RAYNE
Middle Name:GENE
Last Name:SMYTH
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 1:1173 HARTFORD PIKE
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1031
Mailing Address - Country:US
Mailing Address - Phone:401-647-2684
Mailing Address - Fax:
Practice Address - Street 1:7 IVAN ST
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4808
Practice Address - Country:US
Practice Address - Phone:401-725-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01916225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist