Individual
MRS. PATRICIA ELIZABETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
720 OAK AV, CANON CITY, CO 81212-2150
(719) 275-1972
Mailing address
720 OAK AV, CANON CITY, CO 81212-2160
(719) 275-1972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10800557
ACS EDI GATEWAY INC
CO
Enumeration date
10/02/2006
Last updated
07/08/2007
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