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General NPI Number Information
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NPI Number | 1295766004
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Entity Type | Organization
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Legal Business Name | SMOOKE CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 828 HAZELWOOD AVENUE
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City | PITTSBURGH
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State | PA
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Zip | 15217
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Country | US
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Telephone | 412-422-4321
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Fax | 412-422-2896
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Provider Business Mailing Address
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Address Line | 828 HAZELWOOD AVENUE
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City | PITTSBURGH
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State | PA
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Zip | 15217
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Country | US
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Telephone | 412-422-4321
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Fax | 412-422-2896
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Authorized Official
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Title or Position | BUSINESS MGR
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Name | MRS. KERRY W SMOOKE
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Credential | SPOUSE
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Telephone | 412-422-4321
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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 | DC004209L
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License Number State | PA
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