Individual
CHRISTINA AUTUMN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27062 N 178TH AVE, SURPRISE, AZ 85387-1077
(619) 838-1275
Mailing address
27062 N 178TH AVE, SURPRISE, AZ 85387-1077
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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