Individual
KAITLYN ROSE ABERNETHY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
150 COLLEGE AVE, EPHRAIM, UT 84627-1299
(435) 283-7000
Mailing address
521 S 500 E APT F204, AMERICAN FORK, UT 84003-4181
(707) 365-2789
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
11841587-4810
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
01/05/2021
Last updated
01/05/2021
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