Individual
KYLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED
Contact information
Practice address
2401 EXECUTIVE PLAZA RD, SUITE 1, PENSACOLA, FL 32504-8277
(850) 474-5003
(850) 686-8394
Mailing address
2401 EXECUTIVE PLAZA RD, SUITE 1, PENSACOLA, FL 32504-8277
(850) 474-5003
(850) 686-8394
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
PED207
FL
225000000X
Orthotic Fitter
C.F.O.00226
FL
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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