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Individual

LAWRENCE LAMAR SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1350 WABASH AVE, MENTONE, CA 92359-1124
(909) 492-4106
Mailing address
10411 BERYL AVE, MENTONE, CA 92359-1295
(909) 492-4106

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5727
CA

Other

Enumeration date
01/12/2023
Last updated
01/12/2023
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