Jon Maurice Smoots

NPI #1063981710 in Milwaukee, Wisconsin

Provider Information

NPI Number: 1063981710
Entity Type: Individual
Name: Jon Maurice Smoots
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Prevention Professional
Enumeration Date: Nov 23, 2018
Last Updated: Nov 23, 2018

Practice Location

Address: 7710 W. CASPER STREET
City: Milwaukee
State: Wisconsin
ZIP Code: 53216
Phone: (414) 231-1925

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prevention Professional	405300000X	Primary

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