Individual
DR. JACOB GLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
107 COMMERCE DR, SUITE A, GREEN RIVER, WY 82935-6179
(307) 871-4411
Mailing address
107 COMMERCE DR, SUITE A, GREEN RIVER, WY 82935-6179
(307) 871-4411
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
761
WY
Other
Enumeration date
02/11/2016
Last updated
06/06/2016
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