Smith, Justin M
Smith, Justin M is an individual health care provider with primary practice located at 945 S Baxter Ave , Tyler TX 75701-2210. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Smith, Justin M can be contacted via phone (903) 595-2664.Contact Information
Primary practice address
945 S Baxter Ave
Tyler TX 75701-2210
Phone: (903) 595-2664
Fax: (903) 592-8461
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | DC 9333 | Texas |
Profile Details
| NPI number | 1932100500 |
|---|---|
| LBN Legal business name | Smith, Justin M |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Jan 22nd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932100500 | NPPES |
| Texas | MEDICAID | 160985101 |
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