Organization
SMITH CHIROPRACTIC PAIN CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYRONE PRESCOTT SMITH D.C. (PRESIDENT)
(816) 380-3860
Entity
Organization
Contact information
Practice address
2609 CANTRELL RD, HARRISONVILLE, MO 64701-4002
(816) 380-3860
(816) 380-3862
Mailing address
2609 CANTRELL RD, HARRISONVILLE, MO 64701-4002
(816) 380-3860
(816) 380-3862
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2002019357
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386837722
MEDICARE GROUP NPI NUMBER
—
01
—
31744016
BLUE CROSS BLUE SHIELD
—
01
—
31751019
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/20/2007
Last updated
10/11/2007
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