Provider Demographics
NPI:1629179692
Name:SMITH, RON J (PT)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:500 UNIVERSITY AVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825
Mailing Address - Country:US
Mailing Address - Phone:916-437-0570
Mailing Address - Fax:916-437-0470
Practice Address - Street 1:500 UNIVERSITY AVE
Practice Address - Street 2:SUITE #100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-437-0570
Practice Address - Fax:916-437-0470
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT29317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist