Individual
MR. JON R. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
907 UPPER FRONT ST, BINGHAMTON, NY 13905-1328
(607) 778-5050
(607) 778-5370
Mailing address
162 BEVIER ST, BINGHAMTON, NY 13904-1015
(607) 727-2498
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000061-1
NY
Other
Enumeration date
04/17/2006
Last updated
07/08/2007
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