Individual
BRIAN LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PRESIDENT
Contact information
Practice address
6718 S WESTERN AVE, OKLAHOMA CITY, OK 73139-1807
(405) 602-1053
(405) 602-1059
Mailing address
6718 S WESTERN AVE, OKLAHOMA CITY, OK 73139-1807
(405) 602-1053
(405) 602-1059
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24186
OK
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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