Individual
TRAVIS CHARLES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 JETT DR, JACKSON, KY 41339-9621
(606) 666-2456
Mailing address
420 JETT DR, JACKSON, KY 41339-9621
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A04016
KY
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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