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Individual

MRS. KELLY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9201 CYPRESS LAKE DR, FORT MYERS, FL 33919-4941
(239) 481-3343
(239) 482-5227
Mailing address
9201 CYPRESS LAKE DR, FORT MYERS, FL 33919-4941
(239) 481-3343
(239) 482-5227

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO 5210
FL

Other

Enumeration date
10/24/2005
Last updated
03/11/2008
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