Individual
NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1991 SPROUL RD STE 200, BROOMALL, PA 19008-3518
(484) 476-6230
Mailing address
316 EDGEMORE RD, SECANE, PA 19018-2718
(610) 675-8225
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
007844
PA
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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