Organization
SMITH CHIROPRACTIC AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PAUL SMITH D.C. (OWNER)
(262) 251-9300
Entity
Organization
Contact information
Practice address
W177N9856 RIVERCREST DR, SUITE 102, GERMANTOWN, WI 53022-4647
(262) 251-9300
(262) 251-9303
Mailing address
W177N9856 RIVERCREST DR, SUITE 102, GERMANTOWN, WI 53022-4647
(262) 251-9300
(262) 251-9303
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2664
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200879351018
BLUE CROSS
WI
01
—
DB5091
RAILROAD MEDICARE
WI
01
—
P00110391
RAILROAD MEDICARE
WI
Enumeration date
02/19/2007
Last updated
10/04/2007
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