Individual
KIMBERLIE SMOTHERMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 FORD CIRCLE DR, WAGONER, OK 74467-7016
(918) 861-3410
Mailing address
1413 FORD CIRCLE DR, WAGONER, OK 74467-7016
(918) 861-3410
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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