Individual
AUTUMN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3727 W MAIN STREET RD, APT A6, BATAVIA, NY 14020-9408
(585) 813-6697
Mailing address
3727 W MAIN STREET RD, APT A6, BATAVIA, NY 14020-9408
(585) 813-6697
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
327972
NY
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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