Organization
AMITY LYNN SMITH, PLLC
Active
Other names
Revolution Wellness and Prevention
Organization subpart
No
Provider details
NPI number
Authorized official
AMITY LYNN SMITH MD (OWNER)
(817) 488-2837
Entity
Organization
Contact information
Practice address
601 ZENA RUCKER RD, STE 105, SOUTHLAKE, TX 76092-6386
(817) 466-2837
(817) 488-6335
Mailing address
601 ZENA RUCKER RD, STE 105, SOUTHLAKE, TX 76092-6386
(817) 466-2837
(817) 488-6335
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
L9802
TX
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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