Individual
MISS GEORGIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1238 W 39TH ST, LORAIN, OH 44053-2844
(440) 960-1493
Mailing address
1238 W 39TH ST, LORAIN, OH 44053-2844
(440) 960-1493
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN. 067056
OH
164W00000X
Licensed Practical Nurse
Primary
PN.067056
OH
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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