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Individual

STEPHEN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
626 E 4TH ST, TONGANOXIE, KS 66086-9219
(913) 333-8085
Mailing address
13140 KANSAS AVE APT A1-101, BONNER SPRINGS, KS 66012-9386
(913) 333-8085

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KS

Other

Enumeration date
11/11/2014
Last updated
11/11/2014
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