Individual
JAKARIAH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51 LIGHTSEY ST, BRUNSON, SC 29911-3750
(803) 346-2066
Mailing address
51 LIGHTSEY ST, BRUNSON, SC 29911-3750
(803) 346-2066
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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