Individual
MS. CLARISSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
3480 CAPITAL AVENUE SW, BATTLE CREEK, MI 49015
(269) 979-3000
(269) 979-9770
Mailing address
3480 CAPITAL AVENUE SW, BATTLE CREEK, MI 49015
(269) 979-3000
(269) 979-9790
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501007288
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A35702
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
07/23/2009
Last updated
07/23/2009
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