Individual
KRISTEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(865) 604-7789
Mailing address
8512 SAN MARCOS DR, KNOXVILLE, TN 37938-2037
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
00112285
CA
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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