Provider Demographics
NPI:1912028911
Name:SMITH, ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:SMITH
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 1:5131 S COLLEGE AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3968
Mailing Address - Country:US
Mailing Address - Phone:970-266-0003
Mailing Address - Fax:970-266-8077
Practice Address - Street 1:5131 S COLLEGE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3968
Practice Address - Country:US
Practice Address - Phone:970-266-0003
Practice Address - Fax:970-266-8077
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor