Individual
KIZZY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 WESLEY AVE, MUSKEGON, MI 49442-2100
(231) 747-7443
Mailing address
1175 WESLEY AVE, MUSKEGON, MI 49442-2100
(231) 747-7443
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381367329
TAX EXCEMPT
MI
Enumeration date
02/01/2022
Last updated
02/01/2022
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