Individual
ANGELIQUE N SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3388 IN BLOOM WAY, AUBURN, GA 30011-2551
(770) 990-4971
Mailing address
3388 IN BLOOM WAY, AUBURN, GA 30011-2551
(770) 990-4971
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
25041817
GA
Other
Enumeration date
03/08/2025
Last updated
03/08/2025
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