Individual
TIMOTHY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.O.
Contact information
Practice address
5510 VETERANS PKWY, COLUMBUS, GA 31904-4491
(706) 323-3461
(706) 324-3414
Mailing address
5510 VETERANS PKWY, COLUMBUS, GA 31904-4491
(706) 323-3461
(706) 324-3414
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
4025
GA
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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