Individual
ALEXIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
23 WILLOW CT, WILLIAMSPORT, IN 47993
(765) 299-6763
Mailing address
23 WILLOW CT, WILLIAMSPORT, IN 47993-1084
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/08/2016
Last updated
06/10/2018
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