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Individual

CARL EDWARD SMITH JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1950 SIMMONS ST, #1045, LAS VEGAS, NV 89106-1569
(702) 557-1464
Mailing address
1950 SIMMONS ST, #1045, LAS VEGAS, NV 89106-1569
(702) 557-1464

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
1403246825
NV

Other

Enumeration date
10/18/2013
Last updated
10/18/2013
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