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Individual

XENOPHON PHILLIP SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
302 ELM ST, MARION, KS 66861
(620) 382-2191
Mailing address
302 ELM ST, MARION, KS 66861-1526
(620) 382-2205

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-01959
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11-01959
PT LICENSE NUMBER
KS
Enumeration date
05/23/2007
Last updated
07/08/2007
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