Individual
REESA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5464
Mailing address
134 RANDOLPH RD, DALLAS, NC 28034-9630
(704) 813-5723
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
77642
NC
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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