Individual
KENNETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
487A NORTH MAIN ST, THAYNE, WY 83127
(307) 883-8877
(307) 883-8876
Mailing address
PO BOX 860, THAYNE, WY 83127-0860
(307) 883-8877
(307) 883-8876
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1828
WY
Other
Enumeration date
11/01/2018
Last updated
07/06/2022
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