Individual
MR. ERIK JOHN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
321 W JEFFERSON ST, APT #2, ROCKFORD, IL 61101-1024
(815) 262-5614
Mailing address
321 W JEFFERSON ST APT 2, ROCKFORD, IL 61101-1024
(815) 262-5614
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
225A2300X
IL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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