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General NPI Number Information
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NPI Number | 1679966857
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Entity Type | Organization
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Legal Business Name | TA SMITH CHIROPRACTIC INC
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 530 TRAFFIC WAY
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3357
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Country | US
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Telephone | 805-489-8592
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Fax | 805-489-9509
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Provider Business Mailing Address
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Address Line | 530 TRAFFIC WAY
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3357
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Country | US
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Telephone | 805-489-8592
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Fax | 805-489-9509
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Authorized Official
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Title or Position | CEO
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Name | DR. TROY SMITH
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Credential | DC
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Telephone | 805-489-8592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 31081
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License Number State | CA
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