Provider Demographics
NPI:1437484425
Name:SMITH, JEFFREY DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DONALD
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:181 S MAIN ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1911
Mailing Address - Country:US
Mailing Address - Phone:585-233-7331
Mailing Address - Fax:888-747-9234
Practice Address - Street 1:181 S MAIN ST
Practice Address - Street 2:SUITE 9
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1911
Practice Address - Country:US
Practice Address - Phone:585-233-7331
Practice Address - Fax:888-747-9234
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor