Individual
LESLIE M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23750 MERCANTILE RD, BEACHWOOD, OH 44122-5906
(216) 464-1695
Mailing address
160 INWOOD BLVD, AVON LAKE, OH 44012-1551
(440) 933-4662
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT002477
OH
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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