Individual
NICANOR SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
836 DONINGTON CIR, LAWRENCEVILLE, GA 30045-3578
(678) 914-6700
Mailing address
836 DONINGTON CIR, LAWRENCEVILLE, GA 30045-3578
(678) 914-6700
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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