Provider Demographics
NPI:1982938643
Name:D.T. SMITH CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:D.T. SMITH CHIROPRACTIC INC.
Other - Org Name:SMITH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:T
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:209-588-1933
Mailing Address - Street 1:169 S SHEPHERD ST
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-4735
Mailing Address - Country:US
Mailing Address - Phone:209-588-1933
Mailing Address - Fax:209-588-1932
Practice Address - Street 1:169 S SHEPHERD ST
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-4735
Practice Address - Country:US
Practice Address - Phone:209-588-1933
Practice Address - Fax:209-588-1932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27643111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty