Individual
RYAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC LAT
Contact information
Practice address
1601 MAPLE ST, CARROLLTON, GA 30118-0001
(678) 839-3968
Mailing address
915 LOVVORN RD APT 503C, CARROLLTON, GA 30117-2618
(251) 362-1531
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002763
GA
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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