Provider Demographics
NPI:1871672030
Name:SMYTH, ANDREW J (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:SMYTH
Suffix:
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 1:106 ACCESS RD
Mailing Address - Street 2:UNIT 7
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5292
Mailing Address - Country:US
Mailing Address - Phone:781-255-5565
Mailing Address - Fax:
Practice Address - Street 1:106 ACCESS RD
Practice Address - Street 2:UNIT 7
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5292
Practice Address - Country:US
Practice Address - Phone:781-255-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39714OtherBCBS PRACTICE ID
MAY36948OtherBCBS PROVIDER ID
MAY39714OtherBCBS PRACTICE ID