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KATINA SMITH
>> Driver >> Other Service ProvidersRegistrant NPI Number: 1366909301
Individual Registrant: KATINA SMITH
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
179 RACE TRACK LN HAYNEVILLE, AL 36040-2045 US
Tel: 334-300-4176 Fax: --
Tel: 334-300-4176 Fax: --
Contact information for business:
179 RACE TRACK LN HAYNEVILLE, AL 36040-2045 US
Tel: 334-300-4176 Fax: --
Tel: 334-300-4176 Fax: --
Registration Information:
NPI: 1366909301
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 172A00000X | Other Service Providers Driver | AL | 6350020 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
