Individual
KEVIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 PEQUOT PARK RD, SUITE 303, WESTBROOK, CT 06498-2856
(860) 399-6411
(860) 399-6822
Mailing address
47 N MAIN ST, WEST HARTFORD, CT 06107-1926
(860) 409-4595
(860) 409-4860
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10619
CT
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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