Nicole Anna Smallwood, OTR/L | |
5651 E 30th St Ste 219, Indianapolis, IN 46218-3368 | |
(317) 297-9000 | |
Not Available |
Full Name | Nicole Anna Smallwood |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 5651 E 30th St Ste 219, Indianapolis, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619681848 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 31007639A (Indiana) | Primary |
Provider Name | Healthpro Heritage Rehab & Fitness Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1053833657 PECOS PAC ID: 6507832573 Enrollment ID: O20171009003264 |
Mailing Address | Practice Location Address |
---|---|
Nicole Anna Smallwood, OTR/L 9245 Hawkins Rd Apt 3d, Indianapolis, IN 46216-3601 Ph: (937) 673-6557 | Nicole Anna Smallwood, OTR/L 5651 E 30th St Ste 219, Indianapolis, IN 46218-3368 Ph: (317) 297-9000 |
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