Basic Information
| Provider Information | |||||||||
| NPI: | 1831709138 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3127 SOUTHWEST DR STE A | ||||||||
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| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724048404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8703368100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 502 E RACE AVE | ||||||||
| Address2: | |||||||||
| City: | SEARCY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721434417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012683400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2020 | ||||||||
| LastUpdateDate: | 12/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | AR | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.