Individual
ABIGAIL L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7000
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1558
WI
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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