Individual
ANGELA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA-PCT
Contact information
Practice address
474 ROY HUIE RD, RIVERDALE, GA 30274-1826
(770) 709-1741
Mailing address
474 ROY HUIE RD, RIVERDALE, GA 30274-1826
(770) 709-1741
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CN000003210
GA
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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