Individual
MR. STEPHEN GERARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
7555 DECATUR RD LOT 128, FORT WAYNE, IN 46816-3349
(260) 348-4418
Mailing address
7555 DECATUR RD LOT 128, FORT WAYNE, IN 46816-3349
(260) 348-4418
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001573A
IN
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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