Provider Demographics
NPI:1548455546
Name:SMITH, COLBY JAMES (DC)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:JAMES
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 1:3500 LATOUCHE ST
Mailing Address - Street 2:SUITE 380
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4260
Mailing Address - Country:US
Mailing Address - Phone:907-770-6325
Mailing Address - Fax:
Practice Address - Street 1:3500 LATOUCHE ST
Practice Address - Street 2:SUITE 380
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4260
Practice Address - Country:US
Practice Address - Phone:907-770-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034807111N00000X
AK563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor