Provider Demographics
NPI:1730198748
Name:SMITH CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:SMITH CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-636-4606
Mailing Address - Street 1:322 4TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:ND
Mailing Address - Zip Code:58045-4905
Mailing Address - Country:US
Mailing Address - Phone:701-636-4606
Mailing Address - Fax:
Practice Address - Street 1:322 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:ND
Practice Address - Zip Code:58045-4905
Practice Address - Country:US
Practice Address - Phone:701-636-4606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN28G92HIOtherMNBCBS GROUP NUMBER
MN39D57BIOtherIND PRO BCBSMN MICHAEL B
NDBIS20056OtherBCBSND MICHAEL BISHOP
MN28G93SMOtherIND PROV BCBSMN AIMEE S
ND611888OtherACN PROVIDER
NDSMI21948OtherBCBSND AIMEE SMITH
NDU78948Medicare UPIN
MN28G93SMOtherIND PROV BCBSMN AIMEE S
NDU88401Medicare UPIN
NDN71141Medicare PIN
NDN20056Medicare PIN
ND611888OtherACN PROVIDER
MN39D57BIOtherIND PRO BCBSMN MICHAEL B