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Individual
DALE KEVIN SMITH
Active
Individual
DALE KEVIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUDIOLOGIST
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
320471-4101
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999000021033 D1463
—
UT
Enumeration date
01/25/2007
Last updated
09/27/2013
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