Individual
EDDIE JAMES SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1551
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1551
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP048795
AZ
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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