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General NPI Number Information
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NPI Number | 1770911380
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Entity Type | Organization
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Legal Business Name | SMITH SPINAL CARE PC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 1103 RUSSELL PKWY
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City | WARNER ROBINS
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State | GA
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Zip | 31088-5537
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Country | US
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Telephone | 478-922-4091
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Fax | 478-929-8822
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Provider Business Mailing Address
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Address Line | 1103 RUSSELL PKWY
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City | WARNER ROBINS
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State | GA
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Zip | 31088-5537
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Country | US
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Telephone | 478-922-4091
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Fax | 478-929-8822
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JAMES CHARLES SMITH
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Credential | DC
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Telephone | 478-922-4091
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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 | 1309
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License Number State | GA
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