Individual
MR. RODERICK MALCOLM SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 FIR ST, GATE CITY, VA 24251-2926
(276) 690-8752
(276) 386-2465
Mailing address
125 FIR ST, GATE CITY, VA 24251-2926
(276) 690-8752
(276) 386-2465
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T65017143
VA
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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