Provider Demographics
NPI:1417156688
Name:SMITH CHIROPRACTIC CARE PLLC
Entity Type:Organization
Organization Name:SMITH CHIROPRACTIC CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WENDELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-788-9001
Mailing Address - Street 1:531 WASHINGTON ST
Mailing Address - Street 2:SUITE 3101
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4084
Mailing Address - Country:US
Mailing Address - Phone:315-788-9001
Mailing Address - Fax:315-788-9001
Practice Address - Street 1:531 WASHINGTON ST
Practice Address - Street 2:SUITE 3101
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4084
Practice Address - Country:US
Practice Address - Phone:315-788-9001
Practice Address - Fax:315-788-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty