Individual
TISHA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
541 SHORTLEAF DR, AVON, IN 46123-8178
(317) 745-4570
Mailing address
1422 10TH ST, DANVILLE, IN 46122-9160
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
07/09/2007
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