Doctor Name: | MRS. TERYLYN DENISE SMITH |
NPI Number: | 1063697878 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.T. |
License Number: | |
Business Practice Address: | 13800 Heacock St Ste. C236 Moreno Valley, CA - 925533339 |
Business Phone Number: | 9516530819 |
Business Fax Number: | 9516562614 |
Mailing Address: | 13800 Heacock St, Ste. C236 MORENO VALLEY |
State: | CA |
Postal Code: | 925533339 |
Phone Number: | 9516530819 |
Fax Number: | 9514653203 |
NPI Enumeration Date: | 12/31/2007 |
NPI Last Update Date: | 03/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Rehabilitation Practitioner |
Taxonomy Specialization: | |
Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |