Individual
KALLIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 500-3500
Mailing address
505 E HORIZON RD, WARD, AR 72176-8608
(870) 613-0870
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT679
AR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/29/2015
Last updated
05/27/2021
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