Individual
GARY K SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
775 PRAIRIE CENTER DR, EDEN PRAIRIE, MN 55344-7314
(952) 944-5314
Mailing address
5124 NICOLLET AVE, MINNEAPOLIS, MN 55419-2616
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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