Provider Demographics
NPI:1538227921
Name:SMITH, JOSEPH ARTHUR (PT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ARTHUR
Last Name:SMITH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:JOE
Other - Middle Name:A
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:50 27TH ST W
Mailing Address - Street 2:SUITE B
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-8601
Mailing Address - Country:US
Mailing Address - Phone:406-651-9099
Mailing Address - Fax:406-651-4332
Practice Address - Street 1:50 27TH ST W
Practice Address - Street 2:SUITE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-8601
Practice Address - Country:US
Practice Address - Phone:406-651-9099
Practice Address - Fax:406-651-4332
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT618PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0348218Medicaid