Individual
IAN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1525 W CARO RD, CARO, MI 48723-9686
(989) 672-0866
Mailing address
4433 ALTADENA DR, BAY CITY, MI 48706-2513
(989) 992-9660
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005601
MI
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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