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1043745003
WILLIE SMITH
RUSTON, LA
NPI
1043745003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-04-27
Last Update Date
2019-05-14
Business Address
WILLIE SMITH
775 SOUTH BONNRT
RUSTON, LA 71270
Phone number: 318-254-7050
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Mailing Address
WILLIE SMITH
1204 OAKDALE ST
RUSTON, LA 71270-5710
Phone number: 318-394-6019
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