Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 1992 | WA |
N | 111NR0400X | Rehabilitation Chiropractor | 1992 | WA |
NPI | 1316072911 |
---|---|
Provider Name | Dr. Nicholas William Smurro |
First Address | Tacoma, WA 98465-1032 |
Second Address | Lakewood, WA 98499-2895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |