Individual
TYLER STOUT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
444 ONE ELEVEN PL, COOKEVILLE, TN 38506-4358
(931) 525-6655
Mailing address
2874 GRANVILLE HWY, GAINESBORO, TN 38562-6180
(931) 267-4675
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
TN
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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