Individual
COREY R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2605 WILLOW STREET PIKE N, WILLOW STREET, PA 17584-9510
(717) 464-2838
(717) 464-3812
Mailing address
2605 WILLOW STREET PIKE N, WILLOW STREET, PA 17584-9510
(717) 464-2838
(717) 464-3812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS010015-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100951404
—
PA
Enumeration date
06/14/2006
Last updated
07/02/2019
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