Individual
SHANNAH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39628 RIVER OAKS DR, PONCHATOULA, LA 70454-6900
(985) 860-7806
Mailing address
39628 RIVER OAKS DR, PONCHATOULA, LA 70454-6900
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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