Healthcare Provider Details

I. General information

NPI: 1447829478
Provider Name (Legal Business Name): ALEXANDER SMITH PT, DPT, SCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N LINDENWOOD DR
OLATHE KS
66062-1276
US

IV. Provider business mailing address

620 N LINDENWOOD DR ATTN: PRECISION HEALTH
OLATHE KS
66062-1276
US

V. Phone/Fax

Practice location:
  • Phone: 913-912-3003
  • Fax: 913-914-0004
Mailing address:
  • Phone: 913-912-3003
  • Fax: 913-914-0004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15572-24
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP052634T
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-06764
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: