Individual
EDWIN BALLARD SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
811 S 12TH ST, LILLINGTON, NC 27546-6865
(866) 825-5057
(866) 636-0357
Mailing address
811 S 12TH ST, LILLINGTON, NC 27546-6865
(866) 825-5057
(866) 636-0357
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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