Provider Demographics
NPI:1548447006
Name:SMITH, BRETT ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ALEXANDER
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 VICTOR AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1450
Mailing Address - Country:US
Mailing Address - Phone:530-223-0583
Mailing Address - Fax:530-223-6316
Practice Address - Street 1:3051 VICTOR AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1450
Practice Address - Country:US
Practice Address - Phone:530-223-0583
Practice Address - Fax:530-223-6316
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor