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Individual
ANDY W SMITH
Active
Individual
ANDY W SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S530067866344
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7799329
HOME HEALTH PROVIDER
MI
Enumeration date
09/29/2015
Last updated
09/29/2015
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