Individual
ELIZABETH SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 SELIG CIR, ATHENS, GA 30602-1501
(706) 542-6521
Mailing address
291 CASA LOMA DR, CENTERVILLE, UT 84014-1216
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
9054808-4810
UT
2255A2300X
Athletic Trainer
Primary
AT002563
GA
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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