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Individual

MARYANN MARIE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8225 LAKE ST, BEAR LAKE, MI 49614
(231) 864-3314
Mailing address
6227 FRANKFORT HWY, BENZONIA, MI 49616-8632
(312) 882-9661

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
11/01/2018
Last updated
06/07/2019
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