Provider Demographics
NPI:1710025259
Name:SMITH CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:SMITH CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-437-2500
Mailing Address - Street 1:654 MORGANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5422
Mailing Address - Country:US
Mailing Address - Phone:724-437-2500
Mailing Address - Fax:724-437-5617
Practice Address - Street 1:654 MORGANTOWN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5422
Practice Address - Country:US
Practice Address - Phone:724-437-2500
Practice Address - Fax:724-437-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005514L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017736900003Medicaid
344939OtherHEALTH ASSURANCE
1443494OtherHIGHMARK
209875OtherUPMC
209875OtherUPMC
U58708Medicare UPIN