Individual
LAUREL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
680 E DEUCE OF CLUBS UNIT B, SHOW LOW, AZ 85901-4829
(928) 596-4580
Mailing address
HC 65 BOX 9506, CONCHO, AZ 85924-8508
(229) 292-9185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
229673
AZ
Other
Enumeration date
06/10/2021
Last updated
11/08/2023
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