| Jessica Smith, | |
|
502 W King St, Kings Mountain, NC 28086-3362 | |
| (855) 983-0488 | |
| (704) 240-3500 |
| Full Name | Jessica Smith |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 502 W King St, Kings Mountain, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700617586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | P23458 (North Carolina) | Primary |
| Provider Name | Kidology Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1730591991 PECOS PAC ID: 3476943887 Enrollment ID: O20211129001112 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Smith, 4114 Lomar Ter, Mount Airy, MD 21771-3909 Ph: () - | Jessica Smith, 502 W King St, Kings Mountain, NC 28086-3362 Ph: (855) 983-0488 |
Dr. Michael Bernard Haas, PT, DPT, CAFS Physical Therapist Medicare: Medicare Enrolled Practice Location: 110 W King St Ste 9, Kings Mountain, NC 28086 Phone: 704-739-5995 | |
Dr. Elizabeth Kay Wells, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 110 W King St Ste 9, Kings Mountain, NC 28086 Phone: 704-739-5995 Fax: 704-739-2442 | |
Johnny Philebaum, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 110 W King St Ste 9, Kings Mountain, NC 28086 Phone: 704-739-5995 |