Provider Demographics
NPI:1659088011
Name:SMITH, ADRIANNE LEE (DACM)
Entity Type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 HOLYOKE AVE
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-5142
Mailing Address - Country:US
Mailing Address - Phone:703-399-0229
Mailing Address - Fax:
Practice Address - Street 1:2207 HOLYOKE AVE
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-5142
Practice Address - Country:US
Practice Address - Phone:703-399-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty