Doctor Name: | KEVIN SMITH |
NPI Number: | 1346626264 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 10619 |
Business Practice Address: | 5 Pequot Park Rd Suite 303 Westbrook, CT - 064982856 |
Business Phone Number: | 8603996411 |
Business Fax Number: | 8603996822 |
Mailing Address: | 47 N Main St, WEST HARTFORD |
State: | CT |
Postal Code: | 061071926 |
Phone Number: | 8604094595 |
Fax Number: | 8604094860 |
NPI Enumeration Date: | 08/03/2015 |
NPI Last Update Date: | 08/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 10619 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |