Provider Demographics
NPI:1336173293
Name:SMITH, AURORA (MPT)
Entity Type:Individual
Prefix:
First Name:AURORA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO 667744
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28266-7744
Mailing Address - Country:US
Mailing Address - Phone:704-392-4057
Mailing Address - Fax:704-392-4788
Practice Address - Street 1:4221 TUCKASEEGEE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-7744
Practice Address - Country:US
Practice Address - Phone:704-392-4057
Practice Address - Fax:704-392-4788
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist