Individual
JUSTIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
731 N KLEIN CIR, DERBY, KS 67037-7011
(316) 719-2400
Mailing address
731 N KLEIN CIR, DERBY, KS 67037-7011
(316) 719-2400
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
11-06331
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-06331
KANSAS PHYSICAL THERAPY LICENSE
KS
Enumeration date
02/03/2023
Last updated
07/18/2025
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