Individual
MRS. MELODY JO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2260 RALEIGH ROAD, ELDORADO, IL 62930
(618) 273-9394
Mailing address
2260 RALEIGH ROAD, ELDORADO, IL 62930
(618) 273-9394
(618) 273-9395
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043081669
IL
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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