Individual
KEVIN W SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
206 MARYLAND AVE, MCCOMB, MS 39648-3926
(601) 250-4815
Mailing address
308 WILDWOOD BLVD, JACKSON, MS 39212-9612
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0089
MS
Other
Enumeration date
08/27/2008
Last updated
03/17/2018
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