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Individual

JARED GLEN SMIDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, MPT

Contact information

Practice address
2001 N STATE ROUTE 7 STE B, PLEASANT HILL, MO 64080-8005
(816) 987-7049
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10971
CO
225100000X
Physical Therapist
11-06384
KS
225100000X
Physical Therapist
Primary
CP004494T
MO

Other

Enumeration date
01/16/2008
Last updated
09/10/2021
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