Individual
CHRISTOPHER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3021 VOYAGER DR, GREEN BAY, WI 54311-8303
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, PREVEA HEALTH, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 496-4705
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1935
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40809300
—
WI
Enumeration date
07/27/2006
Last updated
07/08/2007
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