Individual
MR. MATHEW JAMES SMITH SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.N , CPS
Contact information
Practice address
9390 FORD AVE STE 8, RICHMOND HILL, GA 31324-6420
(912) 756-4713
Mailing address
4286 HARPER RD, METTER, GA 30439-6122
(912) 663-0733
(912) 303-9893
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN059437
GA
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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