Individual
MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 PENMORE PL, COLLEGEVILLE, PA 19426-3983
(610) 952-5126
Mailing address
18 PENMORE PL, COLLEGEVILLE, PA 19426-3983
(610) 952-5126
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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