Individual
MICHELLE LAVERN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
3200 W. CENTRE STREET, PORTAGE, MI 49024
(269) 321-0929
(269) 321-1767
Mailing address
3200 W. CENTRE STREET, PORTAGE, MI 49024
(269) 321-0929
(269) 321-1767
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
5201005222
MI
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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