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General NPI Number Information
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NPI Number | 1336424506
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Entity Type | Organization
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Legal Business Name | L. LEE SMITH, D.C, P.A
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 100 W NEW HAVEN AVE
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City | MELBOURNE
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State | FL
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Zip | 32901-4303
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Country | US
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Telephone | 321-327-7014
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Fax | 321-821-1924
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Provider Business Mailing Address
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Address Line | 220 N BABCOCK ST
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City | MELBOURNE
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State | FL
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Zip | 32935-6717
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Country | US
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Telephone | 321-327-7014
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Fax | 321-821-1924
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. LARRY LEE SMITH
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Credential | D.C
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Telephone | 321-327-7014
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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 | CH7178
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License Number State | FL
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