Provider Demographics
NPI:1164757555
Name:SMITH CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SMITH CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GRAEME
Authorized Official - Middle Name:P
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-373-8899
Mailing Address - Street 1:1100 WHEATON WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4459
Mailing Address - Country:US
Mailing Address - Phone:360-373-8899
Mailing Address - Fax:360-373-8891
Practice Address - Street 1:1100 WHEATON WAY
Practice Address - Street 2:SUITE B
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4459
Practice Address - Country:US
Practice Address - Phone:360-373-8899
Practice Address - Fax:360-373-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty