Individual
MRS. CAROLYN GIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 S MYRTLE AVE, SMITHTON, MO 65350-1038
(660) 343-5317
Mailing address
505 S MYRTLE AVE, SMITHTON, MO 65350-1038
(660) 343-5317
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2004036396
MO
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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