Provider Demographics
NPI:1023588357
Name:SMITHSON, MAKENZI SPINK (DPT)
Entity type:Individual
Prefix:DR
First Name:MAKENZI
Middle Name:SPINK
Last Name:SMITHSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAKENZI
Other - Middle Name:
Other - Last Name:SPINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 412307
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2564
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:3501 FESTIVAL PARK PLZ
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4449
Practice Address - Country:US
Practice Address - Phone:804-930-8280
Practice Address - Fax:804-930-8101
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9308225100000X
NY0434191225100000X
VA2305212540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist