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General NPI Number Information
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NPI Number | 1912236761
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Entity Type | Individual
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Provider Name | AMANDA BRANDNER SMITH OD
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Gender | Female
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 28322 LEWES GEORGETOWN HWY
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City | MILTON
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State | DE
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Zip | 19968-3117
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Country | US
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Telephone | 302-684-2020
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Fax | 302-684-2021
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Provider Business Mailing Address
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Address Line | PO BOX 58
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City | NASSAU
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State | DE
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Zip | 19969-0058
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Country | US
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Telephone | 703-847-8899
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Fax | 703-991-0514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 13-0001341
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | I3-0001341
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License Number State | DE
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