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NPI Code Detail

MEDICARE: SPENCER-SMITH CHIROPRACTIC SC

MEDICARE: SPENCER-SMITH CHIROPRACTIC SC
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
1111N00000XChiropractor3244WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316144009
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPENCER-SMITH CHIROPRACTIC SC
Provider Business Mailing Address
First Line : 435 RIVERCREST CT
Second Line :
City : MUKWONAGO
State : WI
Zip : 53149-1759
Country : US
Telephone Number : 262-363-9552
Fax Number : 262-363-9556
Provider Business Practice Location Address
First Line : 435 RIVERCREST CT
Second Line :
City : MUKWONAGO
State : WI
Zip : 53149-1759
Country : US
Telephone Number : 262-363-9552
Fax Number : 262-363-9556
Authorized Official
Title or Position : OWNER
Name : DR. ERIN SPENCER-SMITH
Credential : DC
Telephone Number : 262-363-9552
Provider Enumeration Date : 06/27/2007
Last Update Date : 03/05/2008

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Directions to “SPENCER-SMITH CHIROPRACTIC SC ” Practice Location

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