Provider Demographics
NPI:1144377813
Name:SMITH, NAILAH ASHA (D C)
Entity Type:Individual
Prefix:DR
First Name:NAILAH
Middle Name:ASHA
Last Name:SMITH
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 PANOLA RD
Mailing Address - Street 2:STE B
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2792
Mailing Address - Country:US
Mailing Address - Phone:770-733-1381
Mailing Address - Fax:866-762-9112
Practice Address - Street 1:3636 PANOLA RD
Practice Address - Street 2:STE B
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2792
Practice Address - Country:US
Practice Address - Phone:770-733-1381
Practice Address - Fax:866-762-9112
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007963111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor