Individual
JON MAURICE SMOOTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7710 W. CASPER STREET, MILWAUKEE, WI 53216
(414) 231-1925
Mailing address
7710 W. CASPER STREET, MILWAUKEE, WI 53216
(414) 231-1925
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
1319081
WI
Other
Enumeration date
11/23/2018
Last updated
11/23/2018
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