Individual
MR. GORDON E SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
833 MAIN ST, RTE 28, S YARMOUTH, MA 02664-5254
(508) 394-1353
(508) 398-2866
Mailing address
833 MAIN ST, RTE 28, S YARMOUTH, MA 02664-5254
(508) 394-1353
(508) 398-2866
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7108
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0365696
—
MA
01
—
BCBS OF MA
Y66769
MA
Enumeration date
11/14/2005
Last updated
07/09/2007
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