Provider Demographics
NPI:1861635187
Name:SMITH, LEE ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANDREW
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:46175 WESTLAKE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5873
Mailing Address - Country:US
Mailing Address - Phone:703-444-1182
Mailing Address - Fax:703-444-1183
Practice Address - Street 1:46175 WESTLAKE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5873
Practice Address - Country:US
Practice Address - Phone:703-444-1182
Practice Address - Fax:703-444-1183
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA104001043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor