LAURENCE H. SMITH, M.D., INC.
Radiology at 4 St, Santa Rosa, CA

License number
California C36737
Category
Radiology
Type
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Owner
Name: MRS. CAROL S WYCKOFF
Title: ADMINISTRATOR
Phone: (707) 525-0100
Address
Address
1701 4Th St SUITE 200, Santa Rosa, CA 95404
National Provider ID: 1558515882
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAURENCE H. SMITH, M.D., INC

Santa Rosa, CA

Status:
Inactive
Registration:
Oct 30, 2003
Addresses:
PO Box 3505, Santa Rosa, CA 95402 (Physical)
1701 4 St, Santa Rosa, CA 95404
State ID:
C2563430
Business type:
Articles of Incorporation
President:
Laurence H. Smith President, inactive
Agent:
Laurence H Smith,Santa Rosa, CA 95404 (Physical)

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