Provider Demographics
NPI:1104935345
Name:SMITH, RACHEL C (DC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7914 MEMORIAL PKWY SW
Mailing Address - Street 2:SUITE E18
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2264
Mailing Address - Country:US
Mailing Address - Phone:256-881-1321
Mailing Address - Fax:
Practice Address - Street 1:7914 MEMORIAL PKWY SW
Practice Address - Street 2:SUITE E18
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2264
Practice Address - Country:US
Practice Address - Phone:256-881-1321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051504099OtherBLUE CROSS&BLUE SHIELD
AL051504099Medicare ID - Type Unspecified
AL051504099OtherBLUE CROSS&BLUE SHIELD