Individual
MRS. AMANDA MARIE SMITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
716 MARCIA ST SW, WYOMING, MI 49509-4017
(616) 862-5787
Mailing address
716 MARCIA ST SW, WYOMING, MI 49509-4017
(616) 862-5787
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000282
MI
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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