Individual
SUZANNE RENEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
909 E SAN MARNAN DR, WATERLOO, IA 50702-5611
(319) 234-2616
(319) 234-1939
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(319) 234-2616
(319) 234-1939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02096
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154146
—
IA
01
—
421417307C8
JOHN DEERE HEALTH INS PLA
IA
01
—
48266
WELLMARK INS PLAN
IA
Enumeration date
05/19/2006
Last updated
02/04/2022
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