Individual
BRIAN J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
49560 GRATIOT AVE, CHESTERFIELD, MI 48051-2524
(586) 949-3788
(586) 949-4319
Mailing address
49560 GRATIOT AVE, CHESTERFIELD, MI 48051-2524
(586) 949-3788
(586) 949-4319
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301006111
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2301006111
LICENSE
MI
05
—
4322559
—
MI
01
—
950E052230
BCBSM
MI
Enumeration date
04/08/2006
Last updated
12/14/2012
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