Individual
QUESTLEY J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10411 BERYL AVE, MENTONE, CA 92359-1295
(909) 206-8426
Mailing address
10411 BERYL AVE, MENTONE, CA 92359-1295
(909) 206-8426
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3878
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E2640946
—
CA
Enumeration date
03/01/2023
Last updated
03/01/2023
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