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Individual
THOMAS GLENN SMITH
Active
Individual
THOMAS GLENN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
LPTA19978
FL
225100000X
Physical Therapist
Primary
PT013273
GA
Other
Enumeration date
04/20/2007
Last updated
06/19/2018
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