MEDICARE: MICHAEL D. SMITHERS, D.C., P.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	261QM2500X	Medical Specialty Clinic/Center	174623-1202	UT

General Provider Information

NPI Number	:	1265684419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL D. SMITHERS, D.C., P.C.

Provider Business Mailing Address
First Line	:	7084 S 2300 E
Second Line	:	SUITE #110
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3968
Country	:	US
Telephone Number	:	801-942-5814
Fax Number	:	801-942-5897

Provider Business Practice Location Address
First Line	:	7084 S 2300 E
Second Line	:	SUITE #110
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3968
Country	:	US
Telephone Number	:	801-942-5814
Fax Number	:	801-942-5897

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. MICHAEL SMITHERS
Credential	:	M.D., P.C., D.C.
Telephone Number	:	801-942-5814

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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