Individual
MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
254 NEWBY LOOP RD, PIKEVILLE, TN 37367-4234
(423) 774-0887
Mailing address
254 NEWBY LOOP RD, PIKEVILLE, TN 37367-4234
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
69586
TN
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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