Individual
KEVIN D. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
200 SHORT ST, WILLIAMSPORT, IN 47993-1031
(765) 762-6887
(765) 762-6885
Mailing address
1710 HENRY ST, CHAMPAIGN, IL 61821-4302
(217) 402-7052
(765) 762-6885
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001563A
IN
Other
Enumeration date
05/24/2010
Last updated
04/11/2019
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