Individual
JADA N SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
124 US ROUTE 11, CENTRAL SQUARE, NY 13036-9760
(315) 668-0123
Mailing address
76 SHANTY CREEK RD, CENTRAL SQUARE, NY 13036-3412
(315) 380-3299
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031618-1
NY
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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