Individual
JOAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3501 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(325) 947-6718
(325) 947-6613
Mailing address
3501 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7610
(325) 947-6718
(325) 947-6613
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT02800
TX
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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