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Individual

MR. SAMUEL SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
1010 E 200 N, ROOSEVELT, UT 84066-2585
(435) 823-1769
Mailing address
261 E 1080 S, ROOSEVELT, UT 84066-3809
(801) 636-7891

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10685382-4201
UT

Other

Enumeration date
10/27/2022
Last updated
10/27/2022
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