Provider Demographics
NPI:1982606612
Name:SMITH, JANE M (PT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:101 S BRYN MAWR AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3120
Mailing Address - Country:US
Mailing Address - Phone:610-527-3300
Mailing Address - Fax:610-525-5508
Practice Address - Street 1:101 S BRYN MAWR AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3120
Practice Address - Country:US
Practice Address - Phone:610-527-3300
Practice Address - Fax:610-525-5508
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2022-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAPT007389L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S73937Medicare UPIN