Provider Demographics
NPI:1184862815
Name:CHERIE L SMITH CHIROPRACTIC INC
Entity Type:Organization
Organization Name:CHERIE L SMITH CHIROPRACTIC INC
Other - Org Name:BACK TO BALANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-479-0009
Mailing Address - Street 1:274 N EL CAMINO REAL
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2859
Mailing Address - Country:US
Mailing Address - Phone:760-479-0009
Mailing Address - Fax:760-479-0561
Practice Address - Street 1:274 N EL CAMINO REAL
Practice Address - Street 2:SUITE C
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2859
Practice Address - Country:US
Practice Address - Phone:760-479-0009
Practice Address - Fax:760-479-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1053495804OtherNPI SOLE PROPRIETOR #1053495804 SAME DOCTOR NOW INCORPORATED
CA1053495804OtherNPI SOLE PROPRIETOR #1053495804 SAME DOCTOR NOW INCORPORATED