Individual
LARRY ALAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1041 4TH ST, STE B, SANTA ROSA, CA 95404
(707) 526-4777
(707) 526-8809
Mailing address
1041 4TH ST, STE B, SANTA ROSA, CA 95404
(707) 526-4777
(707) 526-8809
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000E21510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704019
—
CA
Enumeration date
09/06/2006
Last updated
05/08/2008
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