Individual
MELANIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
325 LOW WATER LANE, BROOKHAVEN, MS 39601
(601) 754-8286
Mailing address
325 LOW WATER LANE, BROOKHAVEN, MS 39601
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0563
MS
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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