Provider Demographics
NPI:1083770705
Name:SMITH, CAROLYN L (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:L
Last Name: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 1:6677 LEETSDALE DR #100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1587
Mailing Address - Country:US
Mailing Address - Phone:720-236-7135
Mailing Address - Fax:
Practice Address - Street 1:6677 LEETSDALE DR
Practice Address - Street 2:#100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1587
Practice Address - Country:US
Practice Address - Phone:303-399-7301
Practice Address - Fax:303-991-0576
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC492288Medicare PIN