Individual
CHARLES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
99 NAVAHO AVE STE 103, MANKATO, MN 56001-4877
(507) 386-1025
Mailing address
99 NAVAHO AVE STE 103, MANKATO, MN 56001-4877
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2781
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2781
—
MN
Enumeration date
09/07/2017
Last updated
09/07/2017
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