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Individual

JAMIE DAUN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-7503
Mailing address
123 HULL DR, WAYNESVILLE, MO 65583-2360
(785) 608-4375

Taxonomy

Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
1634
AL
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
2016042470
MO

Other

Enumeration date
03/07/2016
Last updated
02/13/2019
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