Individual
BRYAN A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4712
Mailing address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95199674
CA
Other
Enumeration date
05/28/2020
Last updated
05/28/2020
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