Individual
MS. MARY KRISTINA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 N 200 E APT 6, PROVO, UT 84606-7042
(919) 349-3352
Mailing address
515 N 200 E APT 6, PROVO, UT 84606-7042
(919) 349-3352
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
099293224
UT
Other
Enumeration date
12/21/2009
Last updated
12/21/2009
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