Individual
MR. COREY RYAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, PTA, CSCS
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
67 001019
NY
225200000X
Physical Therapy Assistant
66 006329
NY
Other
Enumeration date
05/03/2007
Last updated
09/11/2025
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