Provider Demographics
NPI:1356892772
Name:SMOTHERMAN, THOMAS BRIGGS (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:BRIGGS
Last Name:SMOTHERMAN
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:PO BOX 5192
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-5192
Mailing Address - Country:US
Mailing Address - Phone:229-247-2828
Mailing Address - Fax:
Practice Address - Street 1:701 BAYTREE RD
Practice Address - Street 2:SUITE D
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2880
Practice Address - Country:US
Practice Address - Phone:299-247-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor