Individual
KATHERINE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5640
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2012003355
MO
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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