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Organization
AMITY LYNN SMITH, PLLC
Active
Organization
AMITY LYNN SMITH, PLLC
Active
Other names
Revolution Wellness and Prevention
Organization subpart
No
Provider details
NPI number
Authorized official
AMITY LYNN SMITH MD (OWNER)
(817) 488-2837
Entity
Organization
Contact information
Practice address
601 ZENA RUCKER RD, STE 105, SOUTHLAKE, TX 76092-6386
(817) 466-2837
(817) 488-6335
Mailing address
601 ZENA RUCKER RD, STE 105, SOUTHLAKE, TX 76092-6386
(817) 466-2837
(817) 488-6335
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
L9802
TX
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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