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Individual

DR. TRACY JON SMART

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
708 BRIDGE ST, PARK RAPIDS, MN 56470-1215
(218) 732-7261
(218) 732-7261
Mailing address
PO BOX 208, PARK RAPIDS, MN 56470-0208
(218) 732-7261
(218) 732-7261

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2466
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2C941SM
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
06/24/2005
Last updated
07/08/2007
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