Individual
JODI BROOKE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-6606
(215) 707-6428
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(157) 076-6006
(215) 707-6428
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA052775
PA
Other
Enumeration date
09/20/2012
Last updated
04/06/2018
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