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Individual

MR. KENNETH A SMOOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2400 NEW HOPE CHURCH RD, RALEIGH, NC 27604-2612
(347) 484-8391
Mailing address
2400 NEW HOPE CHURCH RD, RALEIGH, NC 27604-2612
(347) 484-8391

Taxonomy

Speciality
Code
Description
License number
State
2278P4000X
Patient Transport Certified Respiratory Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
84-3418877
NC
Enumeration date
10/21/2019
Last updated
10/21/2019
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