Provider Demographics
NPI:1205385085
Name:WRIGHT SMITH, CAROL (DC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:WRIGHT 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:PO BOX 3531
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-3531
Mailing Address - Country:US
Mailing Address - Phone:901-466-3663
Mailing Address - Fax:901-465-9990
Practice Address - Street 1:7742 HIGHWAY 64
Practice Address - Street 2:SUITE E
Practice Address - City:OAKLAND
Practice Address - State:TN
Practice Address - Zip Code:38060-6061
Practice Address - Country:US
Practice Address - Phone:901-466-3663
Practice Address - Fax:901-465-9990
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor