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Individual

MS. JULIANNE KENDRA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1819 E BIG BEAVER RD, STE 200, TROY, MI 48083-2015
(248) 619-1733
(248) 619-1744
Mailing address
1819 E BIG BEAVER RD, STE 200, TROY, MI 48083-2015
(248) 619-1733
(248) 619-1744

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501015849
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
236742
MEDICARE PROVIDER ID
MI
01
30696
BCBS FACILITY ID
MI
Enumeration date
03/05/2012
Last updated
03/05/2012
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