Individual
MICHELLE SMOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
12530 SE OATFIELD RD, #2, MILWAUKIE, OR 97222-6963
(503) 860-6064
Mailing address
12530 SE OATFIELD RD, #2, MILWAUKIE, OR 97222-6963
(503) 860-6064
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
08956
OR
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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