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Individual

MR. JON DAVID SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
1 UNIVERSITY AVE, ANGOLA, IN 46703-1764
(260) 665-4846
(260) 665-4839
Mailing address
175 LANE 200 LAKE JAMES, ANGOLA, IN 46703-7506
(260) 833-9316
(260) 665-4839

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000440A
IN

Other

Enumeration date
04/10/2006
Last updated
07/08/2007
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