Individual
MR. MICHAEL WILLIAM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
266 33RD AVE S, SUITE 7, SAINT CLOUD, MN 56301
(320) 230-7246
(320) 230-7256
Mailing address
266 33RD AVE S, SUITE 7, SAINT CLOUD, MN 56301-3786
(320) 230-7246
(320) 230-7256
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4457
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
606K6SM
BCBS
MN
Enumeration date
11/07/2006
Last updated
12/21/2007
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