Individual
VICKERY M. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 MALLARD ST, GREENVILLE, SC 29601-3309
(864) 242-9984
(864) 242-2226
Mailing address
15 MALLARD ST, GREENVILLE, SC 29601-3309
(864) 242-9984
(864) 242-2226
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
202418097
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE2605
—
SC
Enumeration date
10/16/2006
Last updated
07/08/2007
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