Individual
CHRISTIAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3353
Mailing address
403 S OHIO ST, HOBART, OK 73651-3227
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5849
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200234750A
—
OK
01
—
5849
OKLAHOMA BOARD OF MEDICAL LICENSURE AND SUPERVISION
OK
Enumeration date
09/26/2023
Last updated
01/17/2025
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