Individual
MR. KELVIN SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LO, CO
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO006148
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS, & PEDORTHICS
—
Enumeration date
01/17/2020
Last updated
08/15/2025
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