Provider Demographics
NPI:1932799145
Name:SMITH-HOWARD, KIMBERLY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:LYNN
Last Name:SMITH-HOWARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 CHAPPELL MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILNER
Mailing Address - State:GA
Mailing Address - Zip Code:30257-3335
Mailing Address - Country:US
Mailing Address - Phone:770-402-8760
Mailing Address - Fax:770-227-4086
Practice Address - Street 1:444 W SOLOMON ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-2832
Practice Address - Country:US
Practice Address - Phone:770-467-8144
Practice Address - Fax:770-229-4086
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor