Provider Demographics
NPI:1770011488
Name:SMALLWOOD, ROI DENNIS ADELA CAYETANO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ROI DENNIS
Middle Name:ADELA CAYETANO
Last Name:SMALLWOOD
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 E CAMELBACK RD STE 444
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1257
Mailing Address - Country:US
Mailing Address - Phone:617-803-7081
Mailing Address - Fax:800-852-1426
Practice Address - Street 1:7150 E CAMELBACK RD STE 444
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-1257
Practice Address - Country:US
Practice Address - Phone:617-803-7081
Practice Address - Fax:800-852-1426
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist