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General NPI Number Information
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NPI Number | 1770638751
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Entity Type | Individual
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Provider Name | AMY SMALLFIELD MS, ATC, RN
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 9TH ST NE
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City | WATERTOWN
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State | SD
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Zip | 57201-2863
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Country | US
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Telephone | 605-881-4264
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Fax | 605-882-5288
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Provider Business Mailing Address
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Address Line | 1120 MAYFAIR DR
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City | WATERTOWN
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State | SD
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Zip | 57201-1444
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Country | US
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Telephone | 605-886-8489
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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 | 0147
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License Number State | SD
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