Individual
CHRISTOPHER SHANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 MIDTOWN ROAD, PERU, IL 61354
(815) 223-8600
(815) 223-4667
Mailing address
1400 MIDTOWN ROAD, PERU, IL 61354
(815) 223-8600
(815) 223-4667
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070.015326
IL
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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