Individual
MONTY RAY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1419 OLIVE ST, EUGENE, OR 97401-3911
(541) 206-4265
Mailing address
1419 OLIVE ST, EUGENE, OR 97401-3911
(541) 206-4265
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
200640518RN
OR
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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