Provider Demographics
NPI:1548310956
Name:SMITH, ANJORAY (MPT)
Entity type:Individual
Prefix:
First Name:ANJORAY
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-778-8384
Mailing Address - Fax:
Practice Address - Street 1:420 W LINFIELD TRAPPE RD BLDG A
Practice Address - Street 2:SUITE 2000
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4278
Practice Address - Country:US
Practice Address - Phone:610-495-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-008539-L174400000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist