NPI 1467786319

Charissa Bethe'L Smith, ATC

Practitioner Athletic Trainer Idaho Falls, ID

Practice location

Address: 1767 Blue Sky Dr, Idaho Falls, ID 83402-4802
Phone: (208) 525-7770
Fax: (208) 525-7778
Mailing address: 98 Poplar St, Blackfoot, ID 83221-1758

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0506221 (NV)

Other Specialist/Technologist providers in Idaho →

Athletic Trainer

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT-386 (ID)

Registry record

NPI: 1467786319
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Sep 2009
Record last updated: 2 Oct 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.