Kelly Wade Smith in Fergus Falls - Chiropractor
Kelly Wade Smith - NPI 1912994476
Kelly Wade Smith is a Chiropractor in Fergus Falls, Minnesota. Kelly Wade Smith practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Kelly Wade Smith is 1912994476. The last update date is 2008-02-27.
Kelly Wade Smith's current location address is 104 W Lincoln Ave, Fergus Falls, Minnesota. You can contact this provider via phone number 2187364113 and fax number 2189984337. The mailing address for Kelly Wade Smith is 104 W Lincoln Ave, Fergus Falls, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Wade Smith |
|---|---|
| Address | 104 W Lincoln Ave, Fergus Falls, Minnesota |
| Phone Number | 2187364113 |
| Fax Number | 2189984337 |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1912994476 |
|---|---|
| Provider Enumeration Date | 2005-09-30 |
| Last Updated Date | 2008-02-27 |
Provider Mailing Address Detail
| Address | 104 W Lincoln Ave |
|---|---|
| City | Fergus Falls |
| State | Minnesota (MN) |
| Post Code | 565372123 |
| Phone Number | 2187364113 |
| Fax Number | 2189984337 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 3250 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4C542SM | MN | BLUE CROSS/BLUE SHIELD | |
| 231907 | MN | CHIROCARE |
Post Comment/ Review Below
What is the unique identifier code issued to Kelly Wade Smith by the Centers for Medicare & Medicaid Services (CMS)?
The Kelly Wade Smith has been assigned the NPI (National Provider Identifier) 1912994476. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical address where Kelly Wade Smith is geographically located?
The Kelly Wade Smith is physically situated at the following location: 104 W Lincoln Ave, Fergus Falls, MN, 565372123.
What is the Kelly Wade Smith's specialty and taxonomy code?
The Kelly Wade Smith's specialty is Chiropractor, and the corresponding taxonomy code is 111N00000X.
When was the Kelly Wade Smith's 1912994476 issued?
The Kelly Wade Smith's 1912994476 was issued on 2005-09-30.
As of what date were the details pertaining to Kelly Wade Smith last refreshed?
The information related to the Kelly Wade Smith, including its address, specialty, and other relevant details, was last updated on 2008-02-27.