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Individual

DR. SHANE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2301 BERLIN TPKE, NEWINGTON, CT 06111-3206
(860) 667-8334
(860) 760-6456
Mailing address
2301 BERLIN TPKE, NEWINGTON, CT 06111-3206
(860) 667-8334
(860) 760-6456

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001553
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050001553CT02
BLUECROSSBLUESHIELD
CT
01
3689845
AETNA
CT
01
672541
CONNECTICARE
CT
Enumeration date
11/06/2006
Last updated
11/24/2012
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