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Individual

MR. SCOTT SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
12250 W NORTH AVE, WAUWATOSA, WI 53226-2063
(414) 476-5303
Mailing address
1807 N 117TH ST, WAUWATOSA, WI 53226-3011
(414) 774-7862

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
WI

Other

Enumeration date
03/30/2006
Last updated
07/08/2007
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