Individual
MRS. KATHERINE DANELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
113 E OAK ST, MC RAE, GA 31055-4339
(229) 868-2174
(229) 868-2175
Mailing address
113 E OAK ST, MC RAE, GA 31055-4339
(229) 868-2174
(229) 868-2175
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1755
GA
Other
Enumeration date
03/25/2009
Last updated
03/25/2009
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