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MR. DONALD LEE SMITH

>> Driver >> Other Service Providers

Registrant NPI Number: 1992830111

Individual Registrant:
MR. DONALD LEE SMITH 
Gender: M
Sole Proprietor

Location and contact information for practice:
12349 FRONTAGE RD P.O.B.426 YUCCA, AZ 86438-0426 US
Tel: 928-208-0254  Fax: 928-766-2363

Contact information for business:
12349 FRONTAGE RD P.O.B.426 YUCCA, AZ 86438-0426 US
Tel: 928-208-0254  Fax: 928-766-2363

Registration Information:
NPI: 1992830111
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172A00000XOther Service Providers
Driver
OR7275614

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
AHCCCS PROVIDER #164739AZ01




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