Individual
SHAUN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
254 CHAPMAN RD, SUITE 112, NEWARK, DE 19702-5413
(888) 757-1951
(877) 757-1951
Mailing address
PO BOX 272195, FORT COLLINS, CO 80527-2195
(888) 757-1951
(877) 757-1951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT-0003548
DE
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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