Individual
CHANTILLY A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1427 E 94TH ST, CLEVELAND, OH 44106-1011
(216) 387-8226
Mailing address
1427 E 94TH ST, CLEVELAND, OH 44106-1011
(216) 387-8226
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OH
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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