Individual
ANTOINE LAMONT SMITH SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HS
Contact information
Practice address
1260 SHOTGUN RD, CHESAPEAKE, VA 23322-4512
(757) 421-1875
Mailing address
1260 SHOTGUN RD, CHESAPEAKE, VA 23322-4512
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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