Individual
MARY S SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPECIALIST
Contact information
Practice address
328 MILWAUKEE AVE, ORANGE PARK, FL 32073-5536
(904) 383-5916
Mailing address
10096 ANDEAN FOX DR, JACKSONVILLE, FL 32222-4153
(904) 383-5916
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
12/05/2021
Last updated
12/05/2021
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