Individual
DR. WAYNE GRAHAM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
158 LAKE ST, SAINT ALBANS, VT 05478-2278
(864) 494-3555
(802) 782-8862
Mailing address
5129 ETHAN ALLEN HWY, SAINT ALBANS, VT 05478-6071
(864) 494-3555
(802) 782-8862
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
006.0064013
VT
111NN1001X
Nutrition Chiropractor
06.0064013
VT
111NR0400X
Rehabilitation Chiropractor
06.0064013
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001617502
MEDICARE PTAN
VT
05
—
CH2393
—
SC
05
—
GCH365
—
SC
Enumeration date
04/04/2006
Last updated
07/13/2012
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