Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | PT0000000222 | TN |
N | 2251X0800X | Physical Therapist - Orthopedic | PT000000000222 | TN |
NPI | 1457436891 |
---|---|
Provider Name | Dr. Danny Dale Smith |
First Address | Elizabethton, TN 37643-3935 |
Second Address | Elizabethton, TN 37643-2559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |