Individual
GARY S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
133 MILL ST, BRADFORD, PA 16701-1408
(814) 362-3668
(814) 362-0540
Mailing address
133 MILL ST, PO BOX 804, BRADFORD, PA 16701-1408
(814) 362-3668
(814) 362-0540
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003540L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012260110002
—
PA
Enumeration date
08/01/2006
Last updated
07/21/2022
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