Provider Demographics
NPI:1467589069
Name:SMUIN, BRYAN D (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:D
Last Name:SMUIN
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 1:319 W 100 S
Mailing Address - Street 2:SUITE B
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2517
Mailing Address - Country:US
Mailing Address - Phone:435-789-7290
Mailing Address - Fax:
Practice Address - Street 1:319 W 100 S
Practice Address - Street 2:SUITE B
Practice Address - City:VERNAL
Practice Address - State:UT
Practice Address - Zip Code:84078-2517
Practice Address - Country:US
Practice Address - Phone:435-789-7290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT96-319206-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000056126Medicare ID - Type Unspecified