National Provider Identifier

Matt Smith, LAT, ATC

Matt Smith, LAT, ATC is listed in the NPPES registry with a primary specialty of Athletic Trainer in Saint Bonaventure, NY and a listed phone number of (716) 375-2230.

NPI 1124481601Saint Bonaventure, NYAthletic Trainer

Profile Overview

NPI
1124481601
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
April 01, 2016
Last Updated
December 05, 2018

Practice Location

  • 3261 W State RD
  • Saint Bonaventure, NY 14778

Phone: (716) 375-2230

Mailing Address

  • 1604 Wilhoit Ave
  • Lewis Center, OH 43035-7933

Specialties

  • Athletic Trainer (2255A2300X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1124481601
Entity Type
Individual
Last Name
Smith
First Name
Matt
Credential
LAT, ATC
Mailing Street Address
1604 Wilhoit Ave
Mailing City
Lewis Center
Mailing State
OH
Mailing ZIP Code
43035-7933
Mailing Country
US
Practice Street Address
3261 W State RD
Practice City
Saint Bonaventure
Practice State
NY
Practice ZIP Code
14778
Practice Country
US
Practice Phone
(716) 375-2230
Enumeration Date
April 01, 2016
Last Updated
December 05, 2018
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X), Student in an Organized Health Care Education/Training Program (390200000X)