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Individual

MS. DIANE MICHELLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
387 THEATRE RD, CARROLLTOWN, PA 15722-7805
(814) 344-8477
(814) 344-2205
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 410-8300
(814) 410-8331

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA053394
PA

Other

Enumeration date
06/24/2008
Last updated
02/18/2010
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