Individual
STACIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10950 FARMINGTON RD, LIVONIA, MI 48150-2753
(248) 787-1281
Mailing address
18275 LEXINGTON, REDFORD, MI 48240-1938
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501001853
MI
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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