Individual
MR. PAUL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
70 TOWER PARKWAY, NEW HAVEN, CT 06511
(860) 834-2731
Mailing address
1910 UNIVERSITY DR, MS 1021, BOISE, ID 83725-0001
(208) 426-3944
(208) 426-1778
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1227
CT
2255A2300X
Athletic Trainer
AT-431
ID
Other
Enumeration date
08/04/2014
Last updated
03/02/2020
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