Individual
CAROLINE MARY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1245 MAPLE AVE, WILMETTE, IL 60091-2542
(847) 431-6633
(847) 431-6633
Mailing address
1245 MAPLE AVE, WILMETTE, IL 60091-2542
(847) 431-6633
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/18/2017
Last updated
09/18/2017
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