Provider Demographics
NPI:1518751346
Name:SMITH, SAWYER A (LMT)
Entity type:Individual
Prefix:
First Name:SAWYER
Middle Name:A
Last Name:SMITH
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 MERRIMAC TRL
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1547
Mailing Address - Country:US
Mailing Address - Phone:703-946-6909
Mailing Address - Fax:
Practice Address - Street 1:3703 MERRIMAC TRL
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-1547
Practice Address - Country:US
Practice Address - Phone:703-946-6909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019015936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist