Most Relevant Information
Provider Data
| NPI Number: | 1003501701 |
| Provider Name: | DORETHA JONES SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 172A00000X |
| Specialty: | Driver |
| License Number: | T69510507 |
Most Important Dates
| Enumeration Date: | 04/07/2023 |
| Last Updated: | 04/07/2023 |
Provider Practice Location
10291 PLANK RD
KENBRIDGE
VA
239444011
Practice Location Phone/Fax
| Phone: | 4343121484 |
| Fax: |
Provider Mailing Location
10291 PLANK RD
KENBRIDGE
VA
239444011
Provider Mailing Phone/Fax
| Phone: | 4343121484 |
| Fax: |