MEDICARE: DR. MICHAEL JOSEPH SMITH JR. PT/AT/DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	5501012409	MI
2	225100000X	Physical Therapist	5501012409	MI

General Provider Information

NPI Number	:	1922066471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOSEPH SMITH JR. PT/AT/DPT

Provider Business Mailing Address
First Line	:	7516 COUNTRY PRIDE LN
Second Line	:
City	:	IMLAY CITY
State	:	MI
Zip	:	48444-9530
Country	:	US
Telephone Number	:	989-390-1825
Fax Number	:

Provider Business Practice Location Address
First Line	:	7516 COUNTRY PRIDE LN
Second Line	:
City	:	IMLAY CITY
State	:	MI
Zip	:	48444-9530
Country	:	US
Telephone Number	:	989-390-1825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	05/04/2025

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Directions to “ DR. MICHAEL JOSEPH SMITH JR. PT/AT/DPT” Practice Location

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