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Individual

AMIELLE LYDIA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
4106 COLUMBIA RD STE 103, MARTINEZ, GA 30907-1482
(706) 863-1440
(706) 863-5418
Mailing address
4106 COLUMBIA RD STE 103, MARTINEZ, GA 30907-1482
(706) 863-1440
(706) 863-5418

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00000
GA

Other

Enumeration date
09/29/2020
Last updated
01/07/2022
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