Provider Demographics
NPI:1508897141
Name:SMITH, CHRIS ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:ALLAN
Last Name:SMITH
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 1:4663 PINTAIL CT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-6276
Mailing Address - Country:US
Mailing Address - Phone:319-447-0376
Mailing Address - Fax:319-378-9292
Practice Address - Street 1:576 BOYSON RD NE
Practice Address - Street 2:SUITE 106
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402
Practice Address - Country:US
Practice Address - Phone:319-378-1515
Practice Address - Fax:319-378-9292
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor