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General NPI Number Information
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NPI Number | 1326903139
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Entity Type | Individual
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Provider Name | RACHEL AMANDA SMITH MAT, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 2220 E BENGAL BLVD
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-5099
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Country | US
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Telephone | 801-826-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 850 N HIGHWAY 89 APT 5F
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-1942
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Country | US
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Telephone | 385-414-1681
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 13538998-4810
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License Number State | UT
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