Provider Demographics
NPI:1710373956
Name:SMITH CHIROPRACTIC & NUTRITION
Entity Type:Organization
Organization Name:SMITH CHIROPRACTIC & NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LLANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CALL SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-638-5611
Mailing Address - Street 1:407 BEATTY DR
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-2505
Mailing Address - Country:US
Mailing Address - Phone:704-817-4745
Mailing Address - Fax:844-828-4745
Practice Address - Street 1:407 BEATTY DR
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-2505
Practice Address - Country:US
Practice Address - Phone:704-817-4745
Practice Address - Fax:844-828-4745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty