Individual
KIERSTON HAILEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2629 DEL PRADO BLVD S, CAPE CORAL, FL 33904-5769
(239) 574-4434
Mailing address
510 NW 19TH PL, CAPE CORAL, FL 33993-7553
(941) 661-4831
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28524
FL
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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