Individual
JESSICA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4949 OGLETOWN STANTON RD, NEWARK, DE 19713-2068
(302) 409-3201
Mailing address
4 GRANT AVE, WILMINGTON, DE 19804-3212
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0000818
DE
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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