Individual
ERIC SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-9767
Mailing address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-9767
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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