Individual
DR. JOSEPH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ATC
Contact information
Practice address
107 RAMONA RD, PORTOLA VALLEY, CA 94028-8135
(808) 341-7262
Mailing address
6238 14TH ST S, FARGO, ND 58104-7230
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
04042217
CA
Other
Enumeration date
12/21/2015
Last updated
08/09/2021
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