Individual
JORDAN MACKENZIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
262 N MAIN ST, MONROE, OH 45050-1236
(513) 461-2273
Mailing address
200 PIKE ST, READING, OH 45215-3226
(513) 502-5833
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006767
OH
363A00000X
Physician Assistant
—
OH
Other
Enumeration date
11/12/2020
Last updated
12/15/2020
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