Individual
OCTAVIUS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
807 20TH ST S, BIRMINGHAM, AL 35205-2713
(205) 933-8101
Mailing address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
55160
AL
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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