Individual
LEATHA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1717 OAK PARK BLVD FL 3, LAKE CHARLES, LA 70601-8990
(337) 494-4900
(337) 494-4936
Mailing address
1717 OAK PARK BLVD FL 3, LAKE CHARLES, LA 70601-8990
(337) 494-4900
(337) 494-4936
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA200643
LA
Other
Enumeration date
08/01/2013
Last updated
08/05/2013
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