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General NPI Number Information
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NPI Number | 1154714053
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Entity Type | Individual
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Provider Name | CHRIS JOHN SMITH
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Gender | Male
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 601 S KINGS DR STE G
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City | CHARLOTTE
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State | NC
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Zip | 28204-3089
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Country | US
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Telephone | 704-333-9055
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Fax |
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Provider Business Mailing Address
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Address Line | 931 JEFFERSON BLVD STE 2001
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City | WARWICK
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State | RI
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Zip | 02886-2245
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Country | US
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Telephone | 401-773-2711
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 1422
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License Number State | NC
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