Provider Demographics
NPI:1548450208
Name:SMITH CHIROPRACTIC AND WELLNESS CLINIC, PC
Entity type:Organization
Organization Name:SMITH CHIROPRACTIC AND WELLNESS CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:615-291-1211
Mailing Address - Street 1:1902 COLUMBIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3928
Mailing Address - Country:US
Mailing Address - Phone:615-591-1211
Mailing Address - Fax:615-591-1559
Practice Address - Street 1:1902 COLUMBIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3928
Practice Address - Country:US
Practice Address - Phone:615-591-1211
Practice Address - Fax:615-591-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1530111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3034873OtherCIGNA
TN4064747OtherBLUE CROSS AND BLUE SHIEL
TN10070425OtherAMERIGROUP
10811030OtherCOACH
TXU74441Medicare UPIN
TN4064747OtherBLUE CROSS AND BLUE SHIEL