Individual
MR. NICHOLAS DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
1525 E BELTLINE AVE NE STE 101, GRAND RAPIDS, MI 49525-4598
(616) 363-7879
Mailing address
538 ELEANOR ST NE, GRAND RAPIDS, MI 49505-4103
(616) 540-9767
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501011228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3343400
—
MI
Enumeration date
06/04/2007
Last updated
07/08/2007
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