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Individual

EDITH ELOIS SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1401 W LOCUST ST, STILWELL, OK 74960-3275
(018) 696-3101
Mailing address
1401 W LOCUST ST, STILWELL, OK 74960-3275
(918) 696-3101

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
1287
OK
225X00000X
Occupational Therapist
Primary
1287
OK

Other

Enumeration date
05/25/2023
Last updated
05/25/2023
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