Individual
MR. MICHELLE RENEE SMYTH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4603
(719) 526-7110
Mailing address
3114 CAPSTAN WAY, COLORADO SPRINGS, CO 80906-8513
(719) 641-7346
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
KY-R2835
KY
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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