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Individual

NATHAN DALE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS,OTR/L

Contact information

Practice address
105 CITATION DR STE B, DANVILLE, KY 40422-8633
(859) 236-2193
Mailing address
2940 FAUBUSH RD, NANCY, KY 42544-6577
(859) 481-4055

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R-3677
KY

Other

Enumeration date
10/05/2016
Last updated
10/05/2016
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