Individual
JOHN DAVID SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 AUTUN RD, PENDLETON, SC 29670-9115
(864) 337-8023
Mailing address
1401 AUTUN RD, PENDLETON, SC 29670-9115
(864) 337-8023
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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