Individual
JUSTYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 534-1350
Mailing address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1300700-TRNE
OH
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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