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General NPI Number Information
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NPI Number | 1780235853
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Entity Type | Individual
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Provider Name | DANIEL SMITH
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Gender | Male
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 83 DEWEY ST
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City | PRESTONSBURG
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State | KY
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Zip | 41653-7923
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Country | US
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Telephone | 980-229-6293
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 ANDREA CIR
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City | PAINTSVILLE
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State | KY
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Zip | 41240-8663
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Country | US
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Telephone | 980-229-6293
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 008796
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License Number State | KY
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