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Individual

DAVID DEWAYNE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
17 DAISY LN, FOXWORTH, MS 39483-4868
(601) 395-7602
Mailing address
17 DAISY LN, FOXWORTH, MS 39483-4868
(601) 395-7602

Taxonomy

Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
800427553
MS

Other

Enumeration date
11/19/2018
Last updated
11/19/2018
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