Most Relevant Information
Provider Data
| NPI Number: | 1003322512 |
| Provider Name: | CALEB SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/19/2017 |
| Last Updated: | 12/19/2017 |
Provider Practice Location
1957 ALVIN RICKEN DR
POCATELLO
ID
832012727
Practice Location Phone/Fax
| Phone: | 2082357800 |
| Fax: |
Provider Mailing Location
25117 SW PARKWAY AVE STE D
WILSONVILLE
OR
970709697
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |