Individual
MS. TINA M CROSS- SMOTHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CLARENDON AVE NW, CANTON, OH 44708-4623
(330) 455-1352
Mailing address
110 CLARENDON AVE NW, CANTON, OH 44708-4623
(330) 455-1352
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RL532515
OH
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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