Individual
JONATHAN LAMONT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
591 N. SHAW LN., EAST SHAW HALL E155, EAST LANSING, MI 48825
(248) 227-8921
Mailing address
34015 LYNCROFT ST, FARMINGTON HILLS, MI 48331-3631
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S530435488908
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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