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Individual

MR. COREY RYAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, PTA, CSCS

Contact information

Practice address
71 PROSPECT AVE, COLUMBIA MEMORIAL HOSPITAL, HUDSON, NY 12534-2907
(518) 828-8206
Mailing address
PO BOX 509, GLASCO, NY 12432-0509
(845) 246-1418

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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