Individual
GARY F SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1574 HENTHORNE DR STE C, MAUMEE, OH 43537-3921
(419) 517-1737
(419) 517-0108
Mailing address
1574 HENTHORNE DR STE C, MAUMEE, OH 43537-3921
(419) 517-1737
(419) 517-0108
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1647
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208590
ANTHEM PIN#
OH
05
—
0911526
—
OH
01
—
350051747
RAILROAD MEDICARE
OH
Enumeration date
05/10/2006
Last updated
12/01/2023
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