Individual
MICHAEL KEITH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
821 N NELLIS BLVD, LAS VEGAS, NV 89110-5339
(702) 452-4563
Mailing address
821 N NELLIS BLVD, LAS VEGAS, NV 89110-5339
(702) 452-4563
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506411
NV
Other
Enumeration date
11/12/2016
Last updated
11/12/2016
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