Provider Demographics
NPI:1902414931
Name:SMELSER, DON ALAN (ATC, LAT, MED)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:ALAN
Last Name:SMELSER
Suffix:
Gender:M
Credentials:ATC, LAT, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 BLUFF CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5172
Mailing Address - Country:US
Mailing Address - Phone:915-478-0208
Mailing Address - Fax:915-833-3165
Practice Address - Street 1:675 BLUFF CANYON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5172
Practice Address - Country:US
Practice Address - Phone:915-478-0208
Practice Address - Fax:915-833-3165
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT03982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer