Healthcare Provider Details

I. General information

NPI: 1245327444
Provider Name (Legal Business Name): SMITH WOLFF CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DELFINO PLACE
CARMEL VALLEY CA
93924
US

IV. Provider business mailing address

6 DELFINO PLACE
CARMEL VALLEY CA
93924
US

V. Phone/Fax

Practice location:
  • Phone: 831-659-5180
  • Fax: 831-659-7569
Mailing address:
  • Phone: 831-659-5180
  • Fax: 831-659-7569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15739
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13875
License Number StateCA

VIII. Authorized Official

Name: DR. WILSON E SMITH
Title or Position: PRESIDENT
Credential: DC
Phone: 831-659-5780