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Individual

PATRICIA SMOOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3940 HENRY ST, INKSTER, MI 48141-3034
(313) 214-9643
Mailing address
3940 HENRY ST, INKSTER, MI 48141-3034
(313) 214-9643

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703106725
MI

Other

Enumeration date
09/23/2015
Last updated
09/23/2015
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