Healthcare Provider Details

I. General information

NPI: 1679481782
Provider Name (Legal Business Name): KADAN LYNN SMITH DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MONUMENT RD
YORK PA
17403-5023
US

IV. Provider business mailing address

1170 FELTON RD
RED LION PA
17356-9324
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT034257
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: