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General NPI Number Information
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NPI Number | 1154510048
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Entity Type | Organization
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Legal Business Name | TAMARA SMITH CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 2260 SEASHORE SHOPPES
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-1364
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Country | US
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Telephone | 757-275-4198
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Fax |
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Provider Business Mailing Address
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Address Line | 2224B SANDALWOOD RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-1322
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Country | US
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Telephone | 757-275-4198
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TAMARA DAWN SMITH
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Credential | DC
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Telephone | 757-275-4198
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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 | 0104556455
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License Number State | VA
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