Individual
KATHLEEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1309 W GUADALUPE RD, SUITE 1, MESA, AZ 85202-9112
(480) 280-9625
Mailing address
8558 E DESERT LN, MESA, AZ 85209-5206
(480) 280-9625
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11771
AZ
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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