Individual
TATUM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1595 STEPHENS DR, YPSILANTI, MI 48198-3244
(734) 272-3538
Mailing address
1595 STEPHENS DR, YPSILANTI, MI 48198-3244
(734) 272-3538
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703089162
MI
Other
Enumeration date
07/25/2016
Last updated
07/25/2016
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