Individual
KENNETHIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5050 AVE MARIA BLVD, AVE MARIA, FL 34142-9505
(813) 679-1496
Mailing address
5909 EGRET LANDING PL, LITHIA, FL 33547-3964
(813) 679-1496
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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