Individual
MR. WAYNE RANDOLPH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HT
Contact information
Practice address
1615 HILL RD STE C, NOVATO, CA 94947-4338
(415) 209-6076
Mailing address
9 WEYBRIDGE CT, OAKLAND, CA 94611-2749
Taxonomy
Speciality
Code
Description
License number
State
246RH0600X
Histology Technician
Primary
25226
IL
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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