Provider Demographics
NPI:1912105081
Name:NORMAN R. SMITH, D.C., LLC
Entity Type:Organization
Organization Name:NORMAN R. SMITH, D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-532-1102
Mailing Address - Street 1:615 E COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-7784
Mailing Address - Country:US
Mailing Address - Phone:803-532-1102
Mailing Address - Fax:803-532-1102
Practice Address - Street 1:615 E COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-7784
Practice Address - Country:US
Practice Address - Phone:803-532-1102
Practice Address - Fax:803-532-1102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7815Medicare UPIN