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Mrs. Gretchen Lee Smith
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NPI Number Detailed Information
Provider Information:
| Name: | Mrs. Gretchen Lee Smith |
| Gender: | F |
| Provider License Number If Given: | C0002171 |
NPI Information:
| NPI: | 1619976149 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 1650 UNION AVE PBG EMPLOYEE HEALTH & WELLNESS CENTER Baltimore, MD 21211 |
| Phone Number: | 4105547874 |
| Fax Number: |
Provider Business Practice Location Address:
| Address: | 1650 UNION AVE PBG EMPLOYEE HEALTH & WELLNESS CENTER Baltimore, MD 21211 |
| Phone Number: | 4105547874 |
| Fax Number: |
Provider Taxonomy:
| Primary: | 363A00000X |
| Secondary (if any): | |
| State: | MD |
