Individual
EDWARD B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Contact information
Practice address
5709 SAINT JOSEPH AVE, STEVENSVILLE, MI 49127-1239
(269) 556-0930
(269) 429-0114
Mailing address
5709 SAINT JOSEPH AVE, STEVENSVILLE, MI 49127-1239
(269) 556-0930
(269) 429-0114
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012887
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00333051
RAILROAD MEDICARE
MI
Enumeration date
07/13/2006
Last updated
12/05/2008
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