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Individual

MR. BRYAN J SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 287-1225
(660) 829-0278
Mailing address
2498 STACEY LN, SEDALIA, MO 65301-6899
(785) 250-7597

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
050802230

Other

Enumeration date
11/11/2009
Last updated
11/11/2009
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