Provider Demographics
NPI:1356764179
Name:PASS, ALLISON SMITH (DC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:SMITH
Last Name:PASS
Suffix:
Gender:F
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:P.O. BOX 30774
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27833
Mailing Address - Country:US
Mailing Address - Phone:910-734-4508
Mailing Address - Fax:
Practice Address - Street 1:2245 STANTONSBURG RD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2868
Practice Address - Country:US
Practice Address - Phone:252-751-3866
Practice Address - Fax:252-757-1000
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor