Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1996 | NE |
NPI | 1003380775 |
---|---|
Provider Name | Dustin Hadley Smith |
First Address | Lincoln, NE 68502-3300 |
Second Address | Lincoln, NE 68502-3313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2019 |
Last Update Date | 21/12/2021 |