Individual
ELLEN MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 CHERRY ST, TOLEDO, OH 43608-2372
(419) 255-2280
Mailing address
3662 E CARMEL DR, CARMEL, IN 46033-4317
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
OH
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/09/2017
Last updated
09/01/2022
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