Individual
MR. JUSTIN RAY SMELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
998 W MAIN ST, GARRISON, TX 75946-2420
(936) 347-3043
(936) 347-3043
Mailing address
998 W MAIN ST, GARRISON, TX 75946-2420
(936) 347-3043
(936) 347-3043
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208449
TX
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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