CORNELL SMITH

WAUKESHA, WI
NPI1306243563
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI  567-39)
Enumeration Date2014-12-03
Last Update Date2014-12-03
Business Address
-- CORNELL SMITH
2103 SUMMIT AVE
WAUKESHA, WI 53188-3106
Phone number: 414-828-0470
Mailing Address
-- CORNELL SMITH
2103 SUMMIT AVE
WAUKESHA, WI 53188-3106
Phone number: