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General NPI Number Information
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NPI Number | 1033782198
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Entity Type | Individual
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Provider Name | DREW JOSEPH SMILEY OTR
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Gender | Male
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Dates
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Enumeration Date | 07/19/2021
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 4118 KALAMAZOO AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-3605
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Country | US
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Telephone | 616-455-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 3551 APPLE HILL RD SE
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City | ADA
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State | MI
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Zip | 49301-8544
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Country | US
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Telephone | 231-250-2310
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201010773
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License Number State | MI
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