Individual
DANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1157 N 300 W, #201, PROVO, UT 84604-6124
(801) 357-1200
Mailing address
125 N MILL RD, UNIT I407, VINEYARD, UT 84058-5601
(385) 225-6260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9833778-4810
UT
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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