Individual
KYLE SMICKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
803 S MAIN ST, WOODSTOCK, VA 22664-1125
(540) 459-5676
Mailing address
62 DEEP CREEK RD, RANSON, WV 25438-4600
(571) 247-2760
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605137
VA
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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