Individual
KELVIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5583
(706) 596-5589
Mailing address
1905 TRANQUIL LN, PHENIX CITY, AL 36867-8542
(334) 480-0852
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/23/2010
Last updated
03/23/2010
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