Individual
JENNIFER K SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2245383
AZ
225700000X
Massage Therapist
Primary
MT11843
SD
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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