Individual
MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
614 CARRIAGE HOUSE DR STE E, JACKSON, TN 38305-4238
(731) 668-4449
(731) 668-4405
Mailing address
1804 HIGHWAY 45 BYP STE 604, JACKSON, TN 38305-4403
(731) 512-1264
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7189
TN
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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