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General NPI Number Information
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NPI Number | 1396054151
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Entity Type | Organization
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Legal Business Name | SMITH CHIROPRACTIC CENTER AT ARROWHEAD
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 06/28/2017
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Provider Practice Location Address
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Address Line | 18275 N 59TH AVE STE F134
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City | GLENDALE
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State | AZ
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Zip | 85308-1281
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Country | US
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Telephone | 602-789-8600
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Fax | 602-789-8601
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Provider Business Mailing Address
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Address Line | PO BOX 11543
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City | GLENDALE
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State | AZ
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Zip | 85318-1543
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Country | US
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Telephone | 602-789-8600
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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. JENNIFER M SMITH
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Credential | DC
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Telephone | 602-789-8600
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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 | 5840
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License Number State | AZ
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