Individual
RYAN ANDREW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 695-6004
Mailing address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 695-6004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6397
OK
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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