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Julie Trust Smith
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NPI Number Detailed Information
Provider Information:
Name: | Julie Trust Smith |
Gender: | F |
Provider License Number If Given: | 201807 |
NPI Information:
NPI: | 1679572275 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 7/18/2005 |
Last Update Date: | 10/24/2012 |
Provider Business Mailing Address:
Address: | 225 BALDWIN AVE Charlotte, NC 28204 |
Phone Number: | 7043761605 |
Fax Number: | 7043358448 |
Provider Business Practice Location Address:
Address: | 225 BALDWIN AVE Charlotte, NC 28204 |
Phone Number: | 7043761605 |
Fax Number: | 7043358448 |
Provider Taxonomy:
Primary: | 363LF0000X |
Secondary (if any): | |
State: | NC |