Individual
JENNIFER LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11475 RIDGE POINT DR, MIDDLEVILLE, MI 49333-8203
15175818885
Mailing address
11475 RIDGE POINT DR, MIDDLEVILLE, MI 49333-8203
15175818885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501002937
MI
2251P0200X
Pediatric Physical Therapist
Primary
5501002937
MI
Other
Enumeration date
07/30/2017
Last updated
07/30/2017
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