Individual
IYANA SIMONE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1655 LAURELWOOD LN, MONTGOMERY, AL 36117-4719
(334) 546-0855
Mailing address
1655 LAURELWOOD LN, MONTGOMERY, AL 36117-4719
(334) 546-0855
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
806266664
BCBS
AL
Enumeration date
08/10/2022
Last updated
08/10/2022
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