Individual
SELMA LUELLA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
775 WOODBURY ROAD, BUILDING B, GREENVILLE, GA 30222
(706) 775-0544
Mailing address
881 ALVERSON RD, LAGRANGE, GA 30241-8194
(706) 884-7468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN162821
GA
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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