Individual
PETER J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5715 KITTERY DR, SIUTE B, COLORADO SPRINGS, CO 80911-3552
(719) 392-3883
(719) 390-7030
Mailing address
5715 KITTERY DR, COLORADO SPRINGS, CO 80911-3551
(719) 392-3883
(719) 390-7030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
616
CO
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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