Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 11500 | TX |
Y | 111N00000X | Chiropractor | 3992 | OK |
NPI | 1003191222 |
---|---|
Provider Name | Dr. Anne Smith |
First Address | Oklahoma City, OK 73112-5638 |
Second Address | Oklahoma City, OK 73112-5638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2011 |
Last Update Date | 13/02/2020 |