Individual
SOPHIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 LAURA ST, CHESAPEAKE, VA 23320-6491
(757) 575-0488
Mailing address
400 LAURA ST, CHESAPEAKE, VA 23320-6491
(757) 575-0488
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/09/2020
Last updated
02/10/2020
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