MEDICARE: DR MICHAEL SMITH CHIROPRACTIC, LLC

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	DC 2128	TN

General Provider Information

NPI Number	:	1588989859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR MICHAEL SMITH CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	2319 VOLUNTEER PKWY
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-6701
Country	:	US
Telephone Number	:	423-217-1700
Fax Number	:	423-217-1717

Provider Business Practice Location Address
First Line	:	2319 VOLUNTEER PKWY
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-6701
Country	:	US
Telephone Number	:	423-217-1700
Fax Number	:	423-217-1717

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	DEBORAH SMITH
Credential	:	CTA
Telephone Number	:	423-217-1700

Provider Enumeration Date	:	03/30/2010
Last Update Date	:	10/06/2022

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