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Individual

KOBY DALE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AT

Contact information

Practice address
6475 S YALE AVE STE 301, TULSA, OK 74136-7815
(918) 494-9300
(918) 494-9624
Mailing address
2488 E 81ST ST STE 290, TULSA, OK 74137-4265
(918) 494-9341
(918) 494-9355

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
580
OK

Other

Enumeration date
05/10/2010
Last updated
06/01/2020
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