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Individual

JIMMY DALE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
11751 ALTA VISTA RD STE 301, FORT WORTH, TX 76244-6443
(817) 337-3400
Mailing address
311 CHISHOLM TRL, KRUM, TX 76249-7178
(940) 736-1815

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
3124138
TX

Other

Enumeration date
06/10/2019
Last updated
06/10/2019
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