Individual
JONATHAN LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
105 W STONE DR, STE 1D, KINGSPORT, TN 37660-3256
(423) 578-1560
(423) 392-7055
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT8024
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
05
—
PENDING
—
VA
Enumeration date
08/31/2009
Last updated
09/23/2009
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