Individual
MR. MICHAEL J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
11400 JULIANNE AVE N, STILLWATER, MN 55082-9436
(612) 454-2401
Mailing address
919 LINWOOD AVE, SAINT PAUL, MN 55105-3203
(603) 387-7186
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303094
MN
183500000X
Pharmacist
2206
NH
Other
Enumeration date
04/18/2007
Last updated
07/23/2014
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