Individual
MR. JEFFREY THOMAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L, CHT
Contact information
Practice address
1715 DOUSMAN ST, GREEN BAY, WI 54303-3211
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001371A
IN
Other
Enumeration date
07/20/2006
Last updated
04/05/2021
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