Individual
KENNETH B SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2191 NORTHLAKE PKWY, BLDG. #11, SUITE-J, TUCKER, GA 30084-4166
(770) 908-5666
(770) 908-5675
Mailing address
2191 NORTHLAKE PKWY, BLDG. #11, SUITE-J, TUCKER, GA 30084-4166
(770) 908-5666
(770) 908-5675
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
11/16/2007
Last updated
02/29/2008
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