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General NPI Number Information
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NPI Number | 1649466566
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Entity Type | Organization
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Legal Business Name | NORTH PORT CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 12/18/2015
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Provider Practice Location Address
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Address Line | 14888 TAMIAMI TRAIL
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City | NORTH PORT
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State | FL
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Zip | 34287-2701
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Country | US
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Telephone | 941-423-2667
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Fax | 941-423-3502
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Provider Business Mailing Address
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Address Line | 14888 TAMIAMI TRAIL
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City | NORTH PORT
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State | FL
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Zip | 34287-2701
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Country | US
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Telephone | 941-423-2667
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Fax | 941-423-3502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY LEE SMITH
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Credential | D.C.
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Telephone | 941-583-2758
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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 | CH8938
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License Number State | FL
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