Individual
DAN MARK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1111 A STREET, PLUMMER, ID 83851
(208) 686-1931
(208) 686-9061
Mailing address
PO BOX 516, PLUMMER, ID 83851-0516
(208) 686-1931
(208) 686-9061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1610
ID
Other
Enumeration date
09/25/2006
Last updated
03/13/2018
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