Individual
BRODY PAUL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1111 N KENTUCKY AVE, WEST PLAINS, MO 65775-2028
(417) 257-5959
Mailing address
PO BOX 1100, WEST PLAINS, MO 65775-1100
(417) 505-0900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1103680
KS
225100000X
Physical Therapist
Primary
2008006961
MO
225100000X
Physical Therapist
2305204861
VA
225100000X
Physical Therapist
PT2724
AR
Other
Enumeration date
05/15/2007
Last updated
11/04/2015
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