Individual
CAITLYN O'NEIL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
4765 JACKSON RD STE B, ANN ARBOR, MI 48103-1847
(734) 926-4710
Mailing address
2861 S UTICA ST, DENVER, CO 80236-2104
(517) 442-5669
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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