Provider Demographics
NPI:1275605958
Name:THOMAS H. SMITH, DC PC
Entity Type:Organization
Organization Name:THOMAS H. SMITH, DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:810-735-9858
Mailing Address - Street 1:2413 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-2214
Mailing Address - Country:US
Mailing Address - Phone:810-962-9901
Mailing Address - Fax:
Practice Address - Street 1:490 W BROAD ST
Practice Address - Street 2:SUITE 500
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-8860
Practice Address - Country:US
Practice Address - Phone:810-735-9858
Practice Address - Fax:810-963-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty