Individual
SEAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3520 N CROSSING CIR, VALDOSTA, GA 31602-1067
(229) 259-0008
Mailing address
3520 N CROSSING CIR, VALDOSTA, GA 31602-1067
(229) 259-0008
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA004981
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA004981
PTA LICENSE NUMBER
GA
Enumeration date
01/04/2023
Last updated
01/04/2023
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