Individual
ALEXANDER JOHN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAT, LAT, ATC
Contact information
Practice address
517 BALL DR, HANOVER, IN 47243-9648
(224) 256-3025
Mailing address
517 BALL DR, HANOVER, IN 47243-9648
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003781A
IN
2255A2300X
Athletic Trainer
AT2206
KY
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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