Individual
GLENDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRIVATE HEALTH CARE
Contact information
Practice address
4160 JACKIE DR, DOUGLASVILLE, GA 30135-4454
(770) 942-1120
(770) 942-6512
Mailing address
4160 JACKIE DR, DOUGLASVILLE, GA 30135-4454
(770) 942-1120
(770) 942-6512
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
048-R-0500
GA
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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