Individual
CHARLES JACOB SMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9918 BELMORE CV, SAN ANTONIO, TX 78245-4419
(314) 471-5331
Mailing address
9918 BELMORE CV, SAN ANTONIO, TX 78245-4419
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
06/19/2019
Last updated
06/19/2019
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