Provider Demographics
NPI:1356540009
Name:SMITH FAMILY CHIROPRACTIC & WELLNESS, L.L.C.
Entity type:Organization
Organization Name:SMITH FAMILY CHIROPRACTIC & WELLNESS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:337-457-1376
Mailing Address - Street 1:200 N 2ND ST
Mailing Address - Street 2:P.O. BOX 1001
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-3338
Mailing Address - Country:US
Mailing Address - Phone:337-457-1376
Mailing Address - Fax:337-457-1379
Practice Address - Street 1:200 N 2ND ST
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-3338
Practice Address - Country:US
Practice Address - Phone:337-457-1376
Practice Address - Fax:337-457-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CN56Medicare PIN