Individual
JIMMY J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
551 2ND ST, TRAER, IA 50675-1138
(319) 478-8515
(319) 478-8497
Mailing address
551 2ND ST, TRAER, IA 50675-1138
(319) 478-8515
(319) 478-8497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
A5449
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070748
—
IA
01
—
02918
WELLMARK BC BS
IA
05
—
1164571451
—
IA
01
—
252196
MIDLANDS CHOICE
IA
01
—
70908
WELLMARK BCBS
IA
Enumeration date
01/09/2007
Last updated
09/16/2013
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