Individual
GARY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
121 MOUNTAIN RD, MOUNTAIN TOP, PA 18707-2312
(570) 474-2912
(570) 474-2912
Mailing address
121 MOUNTAIN RD, MOUNTAIN TOP, PA 18707-2312
(570) 474-2912
(570) 474-2912
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN182823L
PA
Other
Enumeration date
08/12/2005
Last updated
03/03/2010
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