Individual
CHANTELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1756 UNION ST, SCHENECTADY, NY 12309-6314
(518) 374-0474
Mailing address
2 SURREY RD, GLENVILLE, NY 12302-5006
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
219302
NY
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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