Individual
MRS. JILL RAYE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 N STATE ROUTE 2, NEW MARTINSVILLE, WV 26155-2711
(304) 455-5515
Mailing address
PO BOX 87, HANNIBAL, OH 43931-0087
(304) 435-9855
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
29499
WV
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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