Provider Demographics
NPI:1720802903
Name:HEALTHWAYS CHIROPRACTIC, A SMITH PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:HEALTHWAYS CHIROPRACTIC, A SMITH PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-902-0050
Mailing Address - Street 1:15651 IMPERIAL HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-1600
Mailing Address - Country:US
Mailing Address - Phone:562-902-0050
Mailing Address - Fax:562-902-8677
Practice Address - Street 1:15651 IMPERIAL HWY STE 100
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1600
Practice Address - Country:US
Practice Address - Phone:562-902-0050
Practice Address - Fax:562-902-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service