Individual
MRS. MARENA NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
10 ABBOTT ST, DOVER, NH 03820-2713
(603) 767-6530
Mailing address
10 ABBOTT ST, DOVER, NH 03820-2713
(603) 767-6530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0583
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0583
NH ATC LICENSE
NH
01
—
2000015354
BOC
—
Enumeration date
03/30/2020
Last updated
03/30/2020
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