Individual
KIMBERLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1101 W CLAY RD, VERSAILLES, MO 65084-1177
(573) 280-3321
(573) 539-3066
Mailing address
1682 CUP TREE RD, GRAVOIS MILLS, MO 65037-6930
(573) 280-3321
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2006038459
MO
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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