Individual
MRS. KELLIE J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
166 MAIN ST, CONCORD ACADEMY, CONCORD, MA 01742-2445
(978) 402-2341
Mailing address
185 MAIN ST., UNIT F, CONCORD, MA 01742
(978) 402-2341
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1442
MA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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