Healthcare Provider Details
I. General information
NPI: 1548492168
Provider Name (Legal Business Name): CASHA CHIERRE SMITH D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/15/2009
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10800 LOCKWOOD DR STE 204
SILVER SPRING MD
20901-1554
US
IV. Provider business mailing address
10800 LOCKWOOD DR STE 204
SILVER SPRING MD
20901-1554
US
V. Phone/Fax
- Phone: 240-641-5693
- Fax: 240-641-5702
- Phone: 240-641-5693
- Fax: 240-641-5702
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 03626 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 0104556739 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: