MEDICARE: DR. ERICA SMOTHERS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NP0017X	Pediatric Chiropractor	072779	IA

General Provider Information

NPI Number	:	1104227537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICA SMOTHERS D.C.

Provider Business Mailing Address
First Line	:	2205 BLAIRSFERRY XING
Second Line	:	SUITE B
City	:	HIAWATHA
State	:	IA
Zip	:	52233-7900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2205 BLAIRSFERRY XING
Second Line	:	SUITE B
City	:	HIAWATHA
State	:	IA
Zip	:	52233-7900
Country	:	US
Telephone Number	:	319-826-6879
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2014
Last Update Date	:	09/04/2014

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