Provider Demographics
NPI:1003248154
Name:SMITH, CHRIS WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:WILLIAM
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46425 N 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW RIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-7019
Mailing Address - Country:US
Mailing Address - Phone:480-215-7699
Mailing Address - Fax:
Practice Address - Street 1:2655 W CAREFREE HWY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8862
Practice Address - Country:US
Practice Address - Phone:480-221-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor