Individual
BLAKE LANDON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
810 MITCHELL AVE, SALISBURY, NC 28144-6253
(336) 870-7093
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 216-5633
(704) 639-0785
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-12327
NC
Other
Enumeration date
06/30/2022
Last updated
08/19/2022
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