Individual
DARRIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-4397
Mailing address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
500-39
WI
Other
Enumeration date
04/14/2015
Last updated
04/14/2015
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