Individual
LATESE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43 SMITH RD, NEWPORT, RI 02841-1006
(401) 841-3771
Mailing address
36 ELLIOT ST, NEWPORT, RI 02841-1505
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/26/2012
Last updated
03/23/2015
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