Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2011012608 | MO |
NPI | 1003050337 |
---|---|
Provider Name | Dr. Valaree Rosann Smith |
First Address | Lees Summit, MO 64086-7045 |
Second Address | Lees Summit, MO 64086-7045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 17/11/2020 |