Smith Chiropractic Office S.c. | |
22230 75th St Salem WI 53168-9465 | |
(262) 843-3013 | |
(262) 843-2427 |
Full Name | Smith Chiropractic Office S.c. |
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Speciality | Clinic/Center |
Location | 22230 75th St, Salem, Wisconsin |
Authorized Official Name and Position | Bradley James Smith (OWNER/DOCTOR) |
Authorized Official Contact | 2628433013 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Smith Chiropractic Office S.c. 22230 75th St Salem WI 53168-9465 Ph: (262) 843-3013 | Smith Chiropractic Office S.c. 22230 75th St Salem WI 53168-9465 Ph: (262) 843-3013 |
NPI Number | 1194993790 |
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Provider Enumeration Date | 02/15/2008 |
Last Update Date | 02/15/2008 |
Medicare PECOS PAC ID | 8022285097 |
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Medicare Enrollment ID | O20120113000413 |
Identifier | Type | State | Issuer |
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1194993790 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 1784-012 (Wisconsin) | Primary |
Provider Name | Bradley J Smith |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1366582512 PECOS PAC ID: 8921275991 Enrollment ID: I20120113000430 |
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