Doctor Name: | THEODORE MICHAEL SMITH |
NPI Number: | 1629228408 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NCTMB |
License Number: | |
Business Practice Address: | 13818 6760 Rd Montrose, CO - 814017494 |
Business Phone Number: | 9703161930 |
Business Fax Number: | |
Mailing Address: | 1763 Freedom Way, MONTROSE |
State: | CO |
Postal Code: | 814017797 |
Phone Number: | 9703161930 |
Fax Number: | 9709644439 |
NPI Enumeration Date: | 09/29/2008 |
NPI Last Update Date: | 09/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |