Individual
KALEB DELTON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
117 BO BO DR, CRYSTAL SPRINGS, MS 39059-2741
(601) 892-6330
(601) 892-6331
Mailing address
802 LAKELAND DR APT 245, JACKSON, MS 39216-4622
(601) 580-2775
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6894
MS
Other
Enumeration date
06/09/2020
Last updated
06/29/2020
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