Individual
KELLEN MATTHEW SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2197
(757) 953-7021
(757) 953-7560
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2197
(757) 953-7021
(757) 953-7560
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305206466
VA
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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