Individual
MAKALEY JO SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 S YOST AVE, BLOOMINGTON, IN 47403-3188
(812) 822-0605
Mailing address
2010 S YOST AVE, BLOOMINGTON, IN 47403-3188
(812) 822-0605
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261Q00000X
IN
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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