Individual
MR. JOE WILLIE SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
6040 W LISBON AVE STE 200, MILWAUKEE, WI 53210-2116
(414) 447-9890
(414) 447-9891
Mailing address
5128 N 56TH ST, MILWAUKEE, WI 53218-4214
(414) 587-0508
(414) 463-0873
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101Y00000X
WI
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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