Provider Demographics
NPI:1194062927
Name:SMITH, ZACHARY TOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:TOMAS
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:NEW ROCKFORD
Mailing Address - State:ND
Mailing Address - Zip Code:58356-1800
Mailing Address - Country:US
Mailing Address - Phone:701-947-2121
Mailing Address - Fax:701-947-2012
Practice Address - Street 1:207 1ST AVE S
Practice Address - Street 2:
Practice Address - City:NEW ROCKFORD
Practice Address - State:ND
Practice Address - Zip Code:58356-1800
Practice Address - Country:US
Practice Address - Phone:701-947-2121
Practice Address - Fax:701-947-2012
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor