Individual
MRS. TINA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
900 TRAILWOOD DR, BOARDMAN, OH 44512-5007
(330) 726-2575
(330) 726-7789
Mailing address
PO BOX 636988, CINCINNATI, OH 45263-6988
(888) 940-2722
(513) 632-8898
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50002885
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067638
—
OH
Enumeration date
03/25/2009
Last updated
04/25/2022
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