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General NPI Number Information
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NPI Number | 1720227853
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Entity Type | Individual
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Provider Name | NICHOLAS JOHN SMITH D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 13550 NORTHGATE ESTATES DR SUITE 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-7653
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Country | US
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Telephone | 719-599-8119
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Fax | 719-599-0958
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Provider Business Mailing Address
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Address Line | 13550 NORTHGATE ESTATES DR SUITE 210
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-7653
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Country | US
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Telephone | 719-599-8119
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Fax | 719-599-0958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6345
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License Number State | CO
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