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Individual

MICHAEL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT, PTA

Contact information

Practice address
3690 ORANGE PL STE 250, BEACHWOOD, OH 44122-4438
(216) 663-5680
Mailing address
3690 ORANGE PL STE 250, BEACHWOOD, OH 44122-4438

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
08554
OH
225700000X
Massage Therapist
Primary
33.007590
OH

Other

Enumeration date
09/22/2020
Last updated
09/22/2020
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