Provider Demographics
NPI:1851094445
Name:SMOOTH STICKS LLC
Entity Type:Organization
Organization Name:SMOOTH STICKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MOBILE PHLEBOTOMIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-230-7470
Mailing Address - Street 1:2333 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3215
Mailing Address - Country:US
Mailing Address - Phone:859-230-7470
Mailing Address - Fax:859-369-2986
Practice Address - Street 1:2333 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3215
Practice Address - Country:US
Practice Address - Phone:859-230-7470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty