Individual
JOHN WALTON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
1 WASHINGTON AVE STE 3, LOGAN, WV 25601-3965
(304) 792-8689
Mailing address
1 WASHINGTON AVE STE 3, LOGAN, WV 25601-3965
(304) 792-8689
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-9138
WV
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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