Most Relevant Information
Provider Data
| NPI Number: | 1003538562 |
| Provider Name: | MADISON SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86118230 |
Most Important Dates
| Enumeration Date: | 09/13/2022 |
| Last Updated: | 09/13/2022 |
Provider Practice Location
1215 LEE ST
CHARLOTTESVILLE
VA
229080816
Practice Location Phone/Fax
| Phone: | 4349243627 |
| Fax: |
Provider Mailing Location
231 SHAMROCK RD
CHARLOTTESVILLE
VA
229033736
Provider Mailing Phone/Fax
| Phone: | 8043376535 |
| Fax: |