Individual
GAVIN MATHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
869 CALLE CLAVEL, THOUSAND OAKS, CA 91360-4911
(805) 284-5189
Mailing address
869 CALLE CLAVEL, THOUSAND OAKS, CA 91360-4911
(805) 284-5189
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
292011
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT292011
CA
Other
Enumeration date
08/31/2016
Last updated
04/23/2019
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