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Individual

THEISHA MARIE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6080 MASON CREEK CIR UNIT 204, INDIAN LAND, SC 29707-7921
(704) 941-1778
Mailing address
6080 MASON CREEK CIR UNIT 204, INDIAN LAND, SC 29707-7921

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
07/02/2025
Last updated
07/02/2025
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