Individual
KEVIN COURTNEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-2781
Mailing address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-2781
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2696
ID
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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