Provider Demographics
NPI:1265684419
Name:MICHAEL D. SMITHERS, D.C., P.C.
Entity Type:Organization
Organization Name:MICHAEL D. SMITHERS, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC, DC
Authorized Official - Phone:801-942-5814
Mailing Address - Street 1:7084 S 2300 E
Mailing Address - Street 2:SUITE #110
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-3968
Mailing Address - Country:US
Mailing Address - Phone:801-942-5814
Mailing Address - Fax:801-942-5897
Practice Address - Street 1:7084 S 2300 E
Practice Address - Street 2:SUITE #110
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3968
Practice Address - Country:US
Practice Address - Phone:801-942-5814
Practice Address - Fax:801-942-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT174623-1202261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTT78098Medicare UPIN