Individual
SAMANTHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
128 JACKSON ST, BROOKLYN, IA 52211-7711
(641) 522-7221
(641) 522-5816
Mailing address
128 JACKSON ST, PO BOX 527, BROOKLYN, IA 52211-7711
(641) 522-7221
(641) 522-5816
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
083680
IA
Other
Enumeration date
07/14/2016
Last updated
12/14/2016
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