Provider Demographics
NPI:1043374275
Name:SMOTHERS, SETH D (RPT)
Entity type:Individual
Prefix:MRS
First Name:SETH
Middle Name:D
Last Name:SMOTHERS
Suffix:
Gender:M
Credentials:RPT
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 155
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:AL
Mailing Address - Zip Code:35540-0155
Mailing Address - Country:US
Mailing Address - Phone:256-338-6230
Mailing Address - Fax:
Practice Address - Street 1:30510 HIGHWAY 278
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:AL
Practice Address - Zip Code:35540-2139
Practice Address - Country:US
Practice Address - Phone:256-338-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH4006OtherPHYSICAL THERAPY LICENSE