Smith, Kelly
Smith, Kelly is an individual health care provider with primary practice located at 22 Tompkins St , Waterbury CT 06708-1458. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Smith, Kelly can be contacted via phone (203) 419-0381.Contact Information
Primary practice address
22 Tompkins St
Waterbury CT 06708-1458
Phone: (203) 419-0381
Fax: (203) 419-0389
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 5603 | Connecticut |
Profile Details
| NPI number | 1023557501 |
|---|---|
| LBN Legal business name | Smith, Kelly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 17th, 2017 |
| Last updated | Feb 17th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023557501 | NPPES |
| Connecticut | MEDICAID | 004190328 |
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