Individual
TIMOTHY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
901 RIDGE RD, ROXBORO, NC 27573-4511
(336) 588-1016
Mailing address
414 FOXFIRE RD, ASHEBORO, NC 27205-8243
(336) 588-1016
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5431A
NC
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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