Individual
MS. MELISSA ANN SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC, MPAS
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
910 S VIRGINIA AVE, MARION, IL 62959-3256
(618) 993-3186
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
IL
Other
Enumeration date
02/21/2006
Last updated
07/08/2007
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