Individual
SHANE ERIC SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1300 E 66TH ST STE 100, RICHFIELD, MN 55423-2685
(612) 354-3165
Mailing address
1300 E 66TH ST STE 100, RICHFIELD, MN 55423-2685
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6381
MN
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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