Individual
MISS PATRICE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5341 W TONTO RD, GLENDALE, AZ 85308-5026
(623) 572-1260
Mailing address
5341 W TONTO RD, GLENDALE, AZ 85308-5026
(623) 572-1260
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0368
AZ
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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