Organization
FRED L. SMITH DCPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED L SMITH D.C. (OWNER)
(618) 382-4834
Entity
Organization
Contact information
Practice address
908 OAK ST, CARMI, IL 62821-1340
(618) 382-4834
(618) 382-7129
Mailing address
908 OAK ST, CARMI, IL 62821-1340
(618) 382-4834
(618) 382-7129
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038003396
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038003396
—
IL
Enumeration date
04/13/2012
Last updated
04/13/2012
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