Lawrence Lamar Smith
Physical Therapy Assistant in Mentone, CA. Individual provider (NPI-1).
NPI number1104530278
StatusActive
Last updated in NPPESJan 12, 2023
Details
- NPI
- 1104530278
- Entity type
- Individual (NPI-1)
- Name
- Lawrence Lamar Smith
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 12, 2023
- Certification date
- Jan 12, 2023
- Last updated
- Jan 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 5727 | CA | Yes |
Practice location
1350 Wabash AveMentone, CA 92359-1124
Phone 909-492-4106
Mailing address
10411 Beryl AveMentone, CA 92359-1295
Phone 909-492-4106
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