Individual
DR. LATRESE SMITH-WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9660 WICKER AVE, SAINT JOHN, IN 46373-9487
(219) 226-2326
(219) 226-2327
Mailing address
3141 E BENDING CREEK TRL, CRETE, IL 60417-3861
(773) 330-0720
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007706A
IN
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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