Individual
MARK VERNON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
15506 APPLEWOOD LN, KEARNEY, MO 64060-8820
(816) 628-6502
Mailing address
15506 APPLEWOOD LN, KEARNEY, MO 64060-8820
(816) 628-6502
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003519
MO
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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