Individual
VANESSA JO SMOOK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1210 W 18TH ST, STE G01, SIOUX FALLS, SD 57104-4651
(605) 328-2663
(605) 328-3760
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1976
MN
363A00000X
Physician Assistant
Primary
0801
SD
363AS0400X
Surgical Physician Assistant
1308
MN
Other
Enumeration date
10/31/2006
Last updated
03/29/2012
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