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General NPI Number Information
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NPI Number | 1154592319
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Entity Type | Organization
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Legal Business Name | TWIN RIVER CHIROPRACTIC
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 305 FARNUM PIKE
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City | SMITHFIELD
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State | RI
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Zip | 02917-1205
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Country | US
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Telephone | 401-439-2083
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Fax |
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Provider Business Mailing Address
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Address Line | 7 TUCKER RD
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City | GREENVILLE
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State | RI
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Zip | 02828-2207
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. JENNIFER M SMITH
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Credential | D.C.
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Telephone | 401-439-2083
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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 | DCP00555
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License Number State | RI
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