Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 4528 | NC |
Y | 111NN1001X | Nutrition | 4528 | NC |
NPI | 1033166103 |
---|---|
Provider Name | Dr. Llana D Call Smith |
First Address | Belmont, NC 28012-3100 |
Second Address | Belmont, NC 28012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 24/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006432011 | BC/BS OF ILLINOIS (01) | IL |
38010410 | (05) | IL |