Individual
MRS. CARRAH LEE SMITH-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6821 MEDBURY ST, DETROIT, MI 48211-3317
(313) 922-2222
Mailing address
6821 MEDBURY ST, DETROIT, MI 48211-3317
(313) 922-2222
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116022
MI
Other
Enumeration date
01/31/2020
Last updated
09/12/2022
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