Provider Demographics
NPI:1053961920
Name:SMOOT FAMILY CHIROPRACTIC PC
Entity type:Organization
Organization Name:SMOOT FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-751-3939
Mailing Address - Street 1:34 IRIS DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3979
Mailing Address - Country:US
Mailing Address - Phone:831-751-3939
Mailing Address - Fax:
Practice Address - Street 1:34 IRIS DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3979
Practice Address - Country:US
Practice Address - Phone:831-751-3939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty