Individual
MR. TORY L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
128 S CANYON ST, CARLSBAD, NM 88220-5733
(575) 628-0503
(575) 628-3073
Mailing address
PO BOX 2860, ALAMOGORDO, NM 88311-2860
(575) 628-0503
(575) 628-3073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2617
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65579844
—
NM
01
—
NM00Q019
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/26/2005
Last updated
06/09/2011
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