Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | TM00851 | TX |
NPI | 1255312286 |
---|---|
Provider Name | Reed Kelly Smith |
First Address | Fort Collins, CO 80525-4325 |
Second Address | Fort Collins, CO 80524-3929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 23/07/2021 |