Individual
BROOKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 W WILSON AVE, GALLUP, NM 87301-5248
(505) 392-8988
Mailing address
PO BOX 244, CHURCH ROCK, NM 87311-0244
(505) 392-8988
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/21/2016
Last updated
05/21/2016
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