Most Relevant Information
Provider Data
| NPI Number: | 1003281668 |
| Provider Name: | CHRISTOPHER SHANE SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 2251X0800X |
| Specialty: | Physical Therapist |
| License Number: | 070.015326 |
Most Important Dates
| Enumeration Date: | 12/08/2015 |
| Last Updated: | 12/08/2015 |
Provider Practice Location
1400 MIDTOWN ROAD
PERU
IL
61354
Practice Location Phone/Fax
| Phone: | 8152238600 |
| Fax: | 8152234667 |
Provider Mailing Location
1400 MIDTOWN ROAD
PERU
IL
61354
Provider Mailing Phone/Fax
| Phone: | 8152238600 |
| Fax: | 8152234667 |