Provider Demographics
NPI:1780262410
Name:NICHOLAS D. SMITH
Entity type:Organization
Organization Name:NICHOLAS D. SMITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-549-3266
Mailing Address - Street 1:1526 SE 47TH ST
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9613
Mailing Address - Country:US
Mailing Address - Phone:239-549-3266
Mailing Address - Fax:239-549-0727
Practice Address - Street 1:1526 SE 47TH ST
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9613
Practice Address - Country:US
Practice Address - Phone:239-549-3266
Practice Address - Fax:239-549-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty