Individual
MRS. JEAN MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1423 W CENTRE AVE, PORTAGE, MI 49024-5351
(269) 323-4449
Mailing address
343 SHANGRI LA CIR, PLAINWELL, MI 49080-9105
(269) 650-4454
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001802
MI
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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