Individual
HEATHER LYN-NIEBOER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2140 BAUER RD, JENISON, MI 49428-9539
(616) 457-8454
(616) 457-8441
Mailing address
2140 BAUER RD, JENISON, MI 49428-9539
(616) 457-8454
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000712
MI
Other
Enumeration date
09/13/2007
Last updated
04/19/2014
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