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General NPI Number Information
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NPI Number | 1053837906
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Entity Type | Individual
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Provider Name | BREANNA ROSE SMITH DC
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Gender | Female
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 1315 N MOUNTAIN RD
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City | HARRISBURG
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State | PA
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Zip | 17112
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Country | US
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Telephone | 717-652-3663
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Fax | 717-652-2680
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Provider Business Mailing Address
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Address Line | 1315F N MOUNTAIN RD
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City | HARRISBURG
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State | PA
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Zip | 17112-1757
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Country | US
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Telephone | 717-745-8436
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC011280
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License Number State | PA
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