MEDICARE: SMITH WOLFF CHIROPRACTIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	15739	CA
2	111N00000X	Chiropractor	13875	CA

General Provider Information

NPI Number	:	1245327444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH WOLFF CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	6 DELFINO PLACE
Second Line	:
City	:	CARMEL VALLEY
State	:	CA
Zip	:	93924
Country	:	US
Telephone Number	:	831-659-5180
Fax Number	:	831-659-7569

Provider Business Practice Location Address
First Line	:	6 DELFINO PLACE
Second Line	:
City	:	CARMEL VALLEY
State	:	CA
Zip	:	93924
Country	:	US
Telephone Number	:	831-659-5180
Fax Number	:	831-659-7569

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILSON E SMITH
Credential	:	DC
Telephone Number	:	831-659-5780

Provider Enumeration Date	:	10/07/2006
Last Update Date	:	08/22/2020

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