Individual
JOEL MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(417) 836-5461
Mailing address
4408 SUSSEX DR, COLUMBIA, MO 65203-6407
(573) 239-4627
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016025904
MO
Other
Enumeration date
08/27/2016
Last updated
08/27/2016
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