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Individual

CAROLYN DENISE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(910) 520-3869
Mailing address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(910) 520-3869

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
157882
OR

Other

Enumeration date
01/13/2022
Last updated
01/13/2022
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