Individual
DORA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 OLD EDGEFIELD RD, NINETY SIX, SC 29666-9215
(864) 323-9205
Mailing address
1506 OLD EDGEFIELD RD, NINETY SIX, SC 29666-9215
(864) 323-9205
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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