Individual
JESSIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
810 S GREEN ST, SALT LAKE CITY, UT 84102-3512
(801) 608-3872
Mailing address
810 S GREEN ST, SALT LAKE CITY, UT 84102-3512
(801) 608-3872
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10070161-4810
UT
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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