Individual
KELLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
14631 LEE HWY, SUITE 310, CENTREVILLE, VA 20121-5824
(703) 222-5903
(703) 222-3765
Mailing address
14631 LEE HIGHWAY, SUITE 310, CENTREVILLE, VA 20121
(703) 222-5903
(703) 222-3765
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305206672
VA
Other
Enumeration date
11/05/2010
Last updated
12/29/2016
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