Healthcare Provider Details

I. General information

NPI: 1134175417
Provider Name (Legal Business Name): AIMEE LYNNE SMITH D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 4TH AVE SE
HILLSBORO ND
58045-4905
US

IV. Provider business mailing address

322 4TH AVE SE
HILLSBORO ND
58045-4905
US

V. Phone/Fax

Practice location:
  • Phone: 701-636-4606
  • Fax:
Mailing address:
  • Phone: 701-636-4606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number677
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3895
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: