Individual
JESSICA RAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1685 SOUTH 21ST STREET, COLORADO SPRINGS, CO 80904-5123
(719) 329-1774
Mailing address
1685 SOUTH 21ST STREET, COLORADO SPRINGS, CO 80904-5123
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A-0828
NM
225200000X
Physical Therapy Assistant
Primary
PTA.0012947
CO
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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