Healthcare Provider Details

I. General information

NPI: 1457698078
Provider Name (Legal Business Name): JULIE LYNN SMITH DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 OAK PARK DRIVE SUITE 101
FORT COLLINS CO
80525
US

IV. Provider business mailing address

1103 OAK PARK DRIVE SUITE 101
FORT COLLINS CO
80525
US

V. Phone/Fax

Practice location:
  • Phone: 970-206-1868
  • Fax: 970-206-9366
Mailing address:
  • Phone: 970-206-1868
  • Fax: 970-206-9366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6910
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: