Individual
BRANDON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
133 EAGLE CT, MOORESVILLE, NC 28117-8022
(704) 677-5746
Mailing address
133 EAGLE CT, MOORESVILLE, NC 28117-8022
(704) 677-5746
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2878
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000022228
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
NC
01
—
LAT-2878
NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
NC
Enumeration date
01/20/2017
Last updated
01/20/2017
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