| Doctor Name: | CHRISTOPHER SHANE SMITH |
| NPI Number: | 1003281668 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 070.015326 |
| Business Practice Address: | 1400 Midtown Road Peru, IL - 61354 |
| Business Phone Number: | 8152238600 |
| Business Fax Number: | 8152234667 |
| Mailing Address: | 1400 Midtown Road, PERU |
| State: | IL |
| Postal Code: | 61354 |
| Phone Number: | 8152238600 |
| Fax Number: | 8152234667 |
| NPI Enumeration Date: | 12/08/2015 |
| NPI Last Update Date: | 12/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 070.015326 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |