Individual
VIDA TYRESE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 ROSEWOOD LN, NEWPORT NEWS, VA 23602-5414
(180) 439-3241
(804) 800-4066
Mailing address
20 ROSEWOOD LN, NEWPORT NEWS, VA 23602-5414
(180) 439-3241
(804) 800-4066
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
VA
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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