Individual
NICHOLAS JOSEPH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT
Contact information
Practice address
1305 BAEZ ST, RALEIGH, NC 27608-1923
(919) 636-1856
Mailing address
1305 BAEZ ST, RALEIGH, NC 27608-1923
(919) 636-1856
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8892
NC
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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