| Bradley Olin Smith, | |
|
2625 Plymouth Rd, Ann Arbor, MI 48105-2468 | |
| (810) 231-6904 | |
| Not Available |
| Full Name | Bradley Olin Smith |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 12 Years |
| Location | 2625 Plymouth Rd, Ann Arbor, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902233000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5501016438 (Michigan) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ethos Physical Therapy Llc | 6507235298 | 4 |
| Provider Name | Ivyrehab Michigan Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1104337120 PECOS PAC ID: 6901165893 Enrollment ID: O20180123001245 |
| Provider Name | Ethos Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1225757719 PECOS PAC ID: 6507235298 Enrollment ID: O20221220002280 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Olin Smith, 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: (630) 296-2222 | Bradley Olin Smith, 2625 Plymouth Rd, Ann Arbor, MI 48105-2468 Ph: (810) 231-6904 |
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