| Doctor Name: | SUSAN DIANE SMITH |
| NPI Number: | 1154507655 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, NCMT |
| License Number: | 8299 |
| Business Practice Address: | 1262 Bergen Pkwy Unit E10 Evergreen, CO - 804399546 |
| Business Phone Number: | 3036747889 |
| Business Fax Number: | 3036748117 |
| Mailing Address: | 1826 Clark Rd, BAILEY |
| State: | CO |
| Postal Code: | 804211212 |
| Phone Number: | 3038164494 |
| Fax Number: | 3038164494 |
| NPI Enumeration Date: | 01/14/2008 |
| NPI Last Update Date: | 01/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 8299 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |