Individual
ELIZABETH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 10TH ST, 103 TENTH ST., COLUMBIA, LA 71418-3306
(318) 307-9937
(318) 649-2387
Mailing address
PO BOX 1882, 103 TENTH ST., COLUMBIA, LA 71418-1882
(318) 307-9937
(318) 649-2387
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
172A00000X
LA
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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