Provider Demographics
NPI:1164488599
Name:SMITH, DAVID DUANE (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DUANE
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LANGLEY AFB
Mailing Address - State:VA
Mailing Address - Zip Code:23665-2025
Mailing Address - Country:US
Mailing Address - Phone:757-764-8526
Mailing Address - Fax:757-764-8491
Practice Address - Street 1:39 ASH AVE
Practice Address - Street 2:
Practice Address - City:LANGLEY AFB
Practice Address - State:VA
Practice Address - Zip Code:23665-2011
Practice Address - Country:US
Practice Address - Phone:757-764-8526
Practice Address - Fax:757-764-8491
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor