Individual
MOLLY SUSAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
57 SMITHS HILL RD, MANCHESTER CENTER, VT 05255-9600
(802) 733-1160
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2020
Last updated
02/23/2022
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