Individual
ANNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, AT
Contact information
Practice address
639 38TH ST, ROCK ISLAND, IL 61201-2210
(309) 794-8794
Mailing address
1100 COVENTRY CIR, LANCASTER, OH 43130-4173
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002537
IL
2255A2300X
Athletic Trainer
AT002785
OH
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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