Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH 9119 | FL |
NPI | 1003913161 |
---|---|
Provider Name | Dr. Peter A Smith |
First Address | Pensacola, FL 32514-5525 |
Second Address | Pensacola, FL 32514-5525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 17/07/2013 |