Individual
DEREK LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
204 SEMINARY ST, WARSAW, MO 65355
(660) 438-6993
Mailing address
33700 HILTY AVE, WARSAW, MO 65355-5245
(417) 855-9540
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2018037417
MO
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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