Individual
JOSEPH ALEXANDER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2122 N 27TH ST, DECATUR, IL 62526-2191
(217) 876-4976
(217) 423-4485
Mailing address
2122 N 27TH ST, DECATUR, IL 62526-2191
(217) 876-4976
(217) 423-4485
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003602
IL
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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