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General NPI Number Information
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NPI Number | 1023491107
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Entity Type | Organization
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Legal Business Name | SMOOKE CHIROPRACTIC CLINIC
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 828 HAZELWOOD AVE
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City | PITTSBURGH
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State | PA
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Zip | 15217-2967
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Country | US
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Telephone | 412-422-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 828 HAZELWOOD AVE
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City | PITTSBURGH
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State | PA
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Zip | 15217-2967
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Country | US
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Telephone | 412-422-4321
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ANGELO MINELLA
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Credential | DR
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Telephone | 412-302-2127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC011032
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License Number State | PA
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