Individual
JEREMY LYNN SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MA., ATC
Contact information
Practice address
2020 N 12TH ST, GRAND JUNCTION, CO 81501-2914
(970) 245-0484
Mailing address
1300 POWELL ST, FRUITA, CO 81521-4106
(970) 858-8729
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINER
CO
Enumeration date
05/10/2006
Last updated
07/08/2007
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