Individual
MRS. CHARLA JENEA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
711 E JACKSON ST, MEXICO, MO 65265-2903
(573) 582-8888
(573) 582-3774
Mailing address
711 E JACKSON ST, MEXICO, MO 65265-2903
(573) 582-8888
(573) 582-3774
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1999137421
MO
Other
Enumeration date
04/01/2022
Last updated
04/01/2022
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