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General NPI Number Information
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NPI Number | 1568382323
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Entity Type | Individual
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Provider Name | JONATHAN RYAN SMITH PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 550 CLUB LN STE 2
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City | CONWAY
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State | AR
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Zip | 72034-3681
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Country | US
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Telephone | 501-932-0814
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Fax | 501-932-0819
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Provider Business Mailing Address
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Address Line | 1435 GARDENIA
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City | CONWAY
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State | AR
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Zip | 72034-8495
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Country | US
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Telephone | 501-932-0814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT3133
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License Number State | AR
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