Individual
KEITH EARL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR L
Contact information
Practice address
2600 OLD CHERRY POINT RD, NEW BERN, NC 28560-6778
(252) 637-4730
Mailing address
PO BOX 3597, NEW BERN, NC 28564-3597
(252) 883-8662
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2603
NC
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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