Individual
MRS. SHANNON RENEE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, ATC
Contact information
Practice address
679 N MAIN ST, SALEM, AR 72576-9451
(870) 895-6006
(870) 895-2626
Mailing address
679 N MAIN ST, SALEM, AR 72576-9451
(870) 895-6006
(870) 895-2626
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT312
AR
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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