Most Relevant Information
Provider Data
| NPI Number: | 1003068628 |
| Provider Name: | KATIE MARIE SMITH PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 2609 |
Most Important Dates
| Enumeration Date: | 10/14/2008 |
| Last Updated: | 10/23/2012 |
Provider Practice Location
32214 ELLINGWOOD TRL
SUITE #210
EVERGREEN
CO
804399779
Practice Location Phone/Fax
| Phone: | 3036792020 |
| Fax: |
Provider Mailing Location
32214 ELLINGWOOD TRL
SUITE #210
EVERGREEN
CO
804399779
Provider Mailing Phone/Fax
| Phone: | 3036792020 |
| Fax: |