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Individual

CAITLYN O'NEIL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501018385
MI
225100000X
Physical Therapist
PTL.0015179
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5501018385
MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS BOARD OF PHYSICAL THERAP
MI
01
PTL.0015179
COLORADO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS AND OCCUPATIO
CO
Enumeration date
09/20/2017
Last updated
06/03/2019
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