Individual
MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2855 CAMPUS DR, PLYMOUTH, MN 55441-2649
(974) 866-3875
Mailing address
17 RED FOX RD, NORTH OAKS, MN 55127-6323
(651) 253-7251
(651) 253-7251
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2562
MN
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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