Provider Demographics
NPI:1316281959
Name:SMITH, HANNAH MURRAY (PTA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MURRAY
Last Name:SMITH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 DANNY BELL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-2026
Mailing Address - Country:US
Mailing Address - Phone:336-953-3214
Mailing Address - Fax:
Practice Address - Street 1:2005 SHANNON GRAY CT
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-9183
Practice Address - Country:US
Practice Address - Phone:336-317-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4319225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant