Provider Demographics
NPI:1821160375
Name:SMUTS, CHARLES B JR (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:B
Last Name:SMUTS
Suffix:JR
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 1:766 E EXCHANGE STREET
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-1059
Mailing Address - Country:US
Mailing Address - Phone:330-376-8628
Mailing Address - Fax:330-376-8629
Practice Address - Street 1:766 E EXCHANGE STREET
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1059
Practice Address - Country:US
Practice Address - Phone:330-376-8628
Practice Address - Fax:330-376-8629
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4289064Medicare UPIN
SM0385601Medicare ID - Type Unspecified