Provider Demographics
NPI:1770754608
Name:GREG G. SMYTH D.C. PLC
Entity type:Organization
Organization Name:GREG G. SMYTH D.C. PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMYTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-810-8601
Mailing Address - Street 1:18777 N 32ND ST
Mailing Address - Street 2:SUITE 80
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3201
Mailing Address - Country:US
Mailing Address - Phone:623-810-8601
Mailing Address - Fax:
Practice Address - Street 1:18777 N 32ND ST
Practice Address - Street 2:SUITE 80
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3201
Practice Address - Country:US
Practice Address - Phone:623-810-8601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty