Individual
KILA CHAMPAIGN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2981 KANELL BLVD, POPLAR BLUFF, MO 63901-4008
(573) 712-2902
Mailing address
PO BOX 819, POPLAR BLUFF, MO 63902-0819
(573) 712-2902
(573) 712-2906
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MO
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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