Individual
MR. ANTONIO LEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
54 LYNWOOD AVE APT 2, WHEELING, WV 26003-5951
(304) 206-1503
Mailing address
54 LYNWOOD AVE APT 2, WHEELING, WV 26003-5951
(304) 206-1503
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
F508489
WV
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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