Organization
LARRY A SMITH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY A SMITH (OWNER)
(707) 526-4777
Entity
Organization
Contact information
Practice address
1041 4TH ST STE B, SANTA ROSA, CA 95404-4329
(707) 526-4777
(707) 526-8809
Mailing address
1041 4TH ST STE B, SANTA ROSA, CA 95404-4329
(707) 526-4777
(707) 526-8809
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E21510
CA
Other
Enumeration date
12/20/2007
Last updated
12/20/2007
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