Healthcare Provider Details

I. General information

NPI: 1265684419
Provider Name (Legal Business Name): MICHAEL D. SMITHERS, D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7084 S 2300 E SUITE #110
SALT LAKE CITY UT
84121-3968
US

IV. Provider business mailing address

7084 S 2300 E SUITE #110
SALT LAKE CITY UT
84121-3968
US

V. Phone/Fax

Practice location:
  • Phone: 801-942-5814
  • Fax: 801-942-5897
Mailing address:
  • Phone: 801-942-5814
  • Fax: 801-942-5897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number174623-1202
License Number StateUT

VIII. Authorized Official

Name: DR. MICHAEL SMITHERS
Title or Position: CHIROPRACTOR
Credential: M.D., P.C., D.C.
Phone: 801-942-5814