Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tyler Jonathon Smith, LAT

Individual provider Athletic Trainer · NPI 1770611261

Tyler Jonathon Smith, LAT is an Athletic Trainer in Boise, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2007
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

2409 N Cribbens Ave
Boise, ID 83713-5239
Phone: (208) 484-2047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT-261 (ID)

Record details

NPI number1770611261
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT
Sole proprietorYes
NPI enumeratedFebruary 28, 2007
Last updated in NPPESJuly 8, 2007
Mailing address1910 University Dr, Ms 1020, Boise, ID 83725-0002

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