Organization
SHANNON D SMITH D. C P.C
Active
Other names
Smith Family Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON D SMITH D.C. (OWNER)
(912) 487-2288
Entity
Organization
Contact information
Practice address
235 N CHURCH ST, HOMERVILLE, GA 31634-2451
(912) 487-2288
(912) 487-2083
Mailing address
235 N CHURCH ST, HOMERVILLE, GA 31634-2451
(912) 487-2288
(912) 487-2083
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5479
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35ZCDDD
PTAN
—
01
—
511G700683
MEDICARE GROUP PTAN
GA
Enumeration date
04/23/2007
Last updated
07/12/2013
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