Provider Demographics
NPI:1720793938
Name:SMYRNA CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SMYRNA CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFRODA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-766-4133
Mailing Address - Street 1:218 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:DE
Mailing Address - Zip Code:19938-7705
Mailing Address - Country:US
Mailing Address - Phone:302-766-4133
Mailing Address - Fax:
Practice Address - Street 1:218 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:DE
Practice Address - Zip Code:19938-7705
Practice Address - Country:US
Practice Address - Phone:302-766-4133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty