Individual
DR. ANGELA SUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
216 S MAIN ST STE 2, CROOKSTON, MN 56716-1939
(218) 281-2020
(218) 281-5997
Mailing address
216 S MAIN ST STE 2, CROOKSTON, MN 56716-1939
(218) 281-2020
(218) 281-5997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3062035
WI
152W00000X
Optometrist
Primary
3074
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457569378
—
MN
05
—
38632000
—
WI
Enumeration date
05/21/2007
Last updated
10/28/2015
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