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Individual

SAMUEL DENNISON SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PAC, ATC

Contact information

Practice address
2200 BRYANT WILLIAMS DR, KLAMATH FALLS, OR 97601-1120
(541) 884-7746
Mailing address
877 QUARRY RD, MIDDLEBURY, VT 05753-8441
(802) 349-2194

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1205273

Other

Enumeration date
09/04/2019
Last updated
10/09/2023
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