Individual
JERRY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 TANGLEWOOD DR, DAWSONVILLE, GA 30534-8140
(706) 867-0106
(706) 864-3368
Mailing address
50 TANGLEWOOD DR, DAWSONVILLE, GA 30534-8140
(706) 867-0106
(706) 864-3368
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PCH005362
GA
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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