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Individual

GRACE LOIS SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
11600 GAYTON RD, RICHMOND, VA 23238-3423
(804) 740-3394
Mailing address
11600 GAYTON RD, HENRICO, VA 23238-3482
(804) 740-3394

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003562
VA

Other

Enumeration date
05/06/2022
Last updated
05/07/2026
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