Individual
KENNETH SMOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
51635 10 MILE RD, SOUTH LYON, MI 48178-9720
(248) 278-1072
(248) 278-1073
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001088
MI
Other
Enumeration date
12/09/2024
Last updated
12/12/2024
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