Individual
MS. MELISSA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
438 KILLIAN AVE RM 101, SHAW AFB, SC 29152-5046
(803) 895-1867
Mailing address
137 HALLING DR, COLUMBIA, SC 29229-6525
(803) 800-4494
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
558
SC
Other
Enumeration date
07/03/2006
Last updated
08/10/2021
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