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Individual

DR. RUSSELL SHANE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2175 CHAMBLISS AVE NW, SUITE D, CLEVELAND, TN 37311-3842
(423) 472-1140
(423) 339-2242
Mailing address
2175 CHAMBLISS AVE NW, SUITE D, CLEVELAND, TN 37311-3842
(423) 472-1140
(423) 339-2242

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
595
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
84739
BLUE CROSS
TN
Enumeration date
02/17/2006
Last updated
12/02/2009
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