Provider Demographics
NPI:1235105537
Name:SMITH, JOHN S (DC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:S
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9882 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1431
Mailing Address - Country:US
Mailing Address - Phone:513-385-2273
Mailing Address - Fax:513-385-2603
Practice Address - Street 1:9882 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1431
Practice Address - Country:US
Practice Address - Phone:513-385-2273
Practice Address - Fax:513-385-2603
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor