Individual
MRS. SUSAN MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
1580 BRANAN FIELD RD, MIDDLEBURG, FL 32068-8427
(904) 214-9102
(904) 214-9054
Mailing address
3310 WILDERNESS CIR, MIDDLEBURG, FL 32068-4128
(904) 714-8101
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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