Provider Demographics
NPI:1033258611
Name:RYTEL-SMITH, STEPHANIE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANN
Last Name:RYTEL-SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4169 ALAYNA LEE CIR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-3702
Mailing Address - Country:US
Mailing Address - Phone:678-432-3303
Mailing Address - Fax:678-432-3307
Practice Address - Street 1:69 OLD JACKSON RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-3095
Practice Address - Country:US
Practice Address - Phone:678-432-3303
Practice Address - Fax:678-432-3307
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006719111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHGZMedicare ID - Type Unspecified