Provider Demographics
NPI:1609151331
Name:LINDA WHEATLAND SMITH, D.C., P.C.
Entity Type:Organization
Organization Name:LINDA WHEATLAND SMITH, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:WHEATLAND
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-721-5390
Mailing Address - Street 1:225 S MERAMEC AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3511
Mailing Address - Country:US
Mailing Address - Phone:314-721-5390
Mailing Address - Fax:314-721-6903
Practice Address - Street 1:225 S MERAMEC AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-3511
Practice Address - Country:US
Practice Address - Phone:314-721-5390
Practice Address - Fax:314-721-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000031568OtherUNSPECIFIED
MO000031568OtherUNSPECIFIED