Individual
KATELYN GRAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-7100
(814) 272-6501
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
OS019215
PA
390200000X
Student in an Organized Health Care Education/Training Program
2011019213
MO
Other
Enumeration date
07/07/2011
Last updated
08/31/2020
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