Individual
MR. SAMUEL LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
80 PHOENIX AVE, WATERBURY, CT 06702-1418
(203) 756-8021
(203) 596-9038
Mailing address
122 MAPLE AVE, SHELTON, CT 06484-2131
(203) 402-0341
(203) 402-0341
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
000491
CT
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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