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Individual

MRS. JEANNINE G SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
126 E. BROADWAY ST., SUITE #22, MISSOULA, MT 59802
(406) 543-9883
(406) 926-1722
Mailing address
126 E BROADWAY ST., SUITE #22, MISSOULA, MT 59802
(406) 543-9883
(406) 926-1722

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
811
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0164073
MT
05
0164084
MT
01
41321
BCBS
MT
Enumeration date
10/18/2006
Last updated
06/02/2014
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