Individual
JORDAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9500 MENTOR AVE STE 100, MENTOR, OH 44060-8702
(440) 352-4880
Mailing address
197 SHORELAND CIR, WILLOWICK, OH 44095-4690
(330) 806-9505
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004178
OH
Other
Enumeration date
12/05/2014
Last updated
03/25/2021
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