Individual
MR. KEITH BARRY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
880 N MIRAMAR AVE, INDIALANTIC, FL 32903
(321) 729-4340
(321) 729-4340
Mailing address
880 N MIRAMAR AVE, INDIALANTIC, FL 32903
(321) 729-4340
(321) 729-4340
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2197
FL
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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