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Individual

MRS. KELLY GEORGE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2031 AVONDALE ST, HUMBOLDT, TN 38343-1810
(731) 784-3655
(731) 784-3651
Mailing address
290 FOREST LAKE DR, HUMBOLDT, TN 38343-8641
(731) 693-7012
(731) 784-3651

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5983
TN

Other

Enumeration date
12/01/2011
Last updated
12/01/2011
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