Individual
MR. DARRELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2907 HOLLAND RD, GREEN BAY, WI 54313-7097
(920) 619-0533
Mailing address
2907 HOLLAND RD, GREEN BAY, WI 54313-7097
(920) 619-0533
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
109612-30
WI
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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