Individual
MR. DOMINIC R. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
(818) 997-7826
Mailing address
6815 NOBLE AVE, VAN NUYS, CA 91405-3796
(818) 901-6600
(818) 997-7826
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT34501
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT34501
LICENSE
CA
Enumeration date
07/14/2008
Last updated
02/02/2012
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