Provider Demographics
NPI:1639247679
Name:SMITH, RYAN MATTHEW (DPT)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MATTHEW
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3345 S HARVARD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-1815
Mailing Address - Country:US
Mailing Address - Phone:918-574-2575
Mailing Address - Fax:918-340-6632
Practice Address - Street 1:3345 S HARVARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-1800
Practice Address - Country:US
Practice Address - Phone:918-574-2575
Practice Address - Fax:918-340-6632
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKPT27832251X0800X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic