Individual
STEPHANIE LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT, CSCS
Contact information
Practice address
3400 BROADWAY, SAVANNAH CENTER 217, GARY, IN 46408-1101
(219) 981-5636
Mailing address
600 LEGACY PLAZA EAST, LAPORTE, IN 46350
(219) 326-2663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002016A
IN
Other
Enumeration date
01/09/2012
Last updated
01/24/2017
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