| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CORAN SMITH | 1790436277 | 2022-01-16 |
Coran Smith is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1790436277. Registration indicates Coran Smith is a provider of services with a specialization in Other Service Providers, Driver (Driver, ) (Driver, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Coran Smith |
| Practice Office Address | 517 W 103RD PL CHICAGO, IL US |
| Practice Office Telephone | 7738125675 |
| Mailing Address | 1001 S MAIN ST STE 700 KALISPELL, MT 599015635 US |
| Business Telephone | 7738125675 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 6545 W Dickens Ave | Chicago, IL 607073482 | 7738125675 |
| Code | Practice | License No State |
|---|---|---|
| 172A00000X PRIMARY | Other Service Providers Driver Driver Driver Other Service Providers | S53010478239
IL |