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Individual

MR. RANDY D SMART JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ABOC, NCLEC, RDO

Contact information

Practice address
3840 BROAD ST STE 5, SAN LUIS OBISPO, CA 93401-7186
(805) 787-0182
(805) 787-0150
Mailing address
3840 BROAD ST STE 5, SAN LUIS OBISPO, CA 93401-7186
(805) 215-8571

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
CA

Other

Enumeration date
08/14/2018
Last updated
08/14/2018
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