Individual
MISS LAUREN ELIZABETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
610 LAFAYETTE AVE NE, GRAND RAPIDS, MI 49503-1660
(269) 760-5085
Mailing address
610 LAFAYETTE AVE NE, GRAND RAPIDS, MI 49503-1660
(269) 760-5085
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5501017854
MI
2255A2300X
Athletic Trainer
2601001124
MI
Other
Enumeration date
11/12/2015
Last updated
10/03/2018
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