MEDICARE: LINDSEY A SMITH 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	111N00000X	Chiropractor	012175	NY

General Provider Information

NPI Number	:	1619242450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY A SMITH D.C.

Provider Business Mailing Address
First Line	:	6385 STATE ROUTE 96
Second Line	:	SUITE 210 PHOENIX MILLS PLAZA
City	:	VICTOR
State	:	NY
Zip	:	14564-1411
Country	:	US
Telephone Number	:	315-730-8646
Fax Number	:

Provider Business Practice Location Address
First Line	:	6385 STATE ROUTE 96
Second Line	:	SUITE 210
City	:	VICTOR
State	:	NY
Zip	:	14564-1411
Country	:	US
Telephone Number	:	315-730-8646
Fax Number	:

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

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	04/25/2012

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