Individual
KATHLEEN A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(218) 786-5400
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(218) 786-5400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10188-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40342600
—
WI
Enumeration date
04/04/2008
Last updated
02/15/2021
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