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1598131310
STACEY ODIS SMITH
SALT LAKE CITY, UT
NPI
1598131310
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2015-08-16
Last Update Date
2015-08-16
Business Address
-- STACEY ODIS SMITH
344 E 100 S STE 301
SALT LAKE CITY, UT 84111-1700
Phone number: 801-322-4257
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Mailing Address
-- STACEY ODIS SMITH
1792 W 1700 N
SALT LAKE CITY, UT 84116-1105
Phone number: 801-671-1115
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