Individual
MICHELLE SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 GAITHER DR, MOUNT LAUREL, NJ 08054-1701
(856) 810-9888
Mailing address
101 GAITHER DR, MOUNT LAUREL, NJ 08054-1701
(856) 810-9888
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00404500
NJ
363A00000X
Physician Assistant
MA057201
PA
Other
Enumeration date
09/24/2014
Last updated
01/31/2017
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