Individual
DORETHA JONES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10291 PLANK RD, KENBRIDGE, VA 23944-4011
(434) 312-1484
Mailing address
10291 PLANK RD, KENBRIDGE, VA 23944-4011
(434) 312-1484
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T69510507
VA
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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