Individual
MISS JENNIFER JADE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA
Contact information
Practice address
1813 W HARVARD AVE STE 432, ROSEBURG, OR 97471-8705
(541) 673-4303
Mailing address
1813 W HARVARD AVE STE 432, ROSEBURG, OR 97471-8705
(541) 673-4303
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
08OR1342
OR
247100000X
Radiologic Technologist
106240
OR
Other
Enumeration date
10/28/2011
Last updated
10/28/2011
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