Individual
MIRANDA ELIZA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 MADISON AVE, MEMPHIS, TN 38103-3403
(901) 448-5560
Mailing address
874 UNION AVE RM 325, MEMPHIS, TN 38103-3514
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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