Individual
JODI R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
101 E 9TH ST, PANA, IL 62557-1716
(217) 562-6328
Mailing address
364 N 300 EAST RD, OCONEE, IL 62553-4119
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004795
IL
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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