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SHANNON DAVIS SMITH DC
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1295894509
Individual Registrant: SHANNON DAVIS SMITH DC
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
235 NORTH CHURCH STREET HOMERVILLE, GA 31634 US
Tel: 912-487-2288 Fax: 912-487-2083
Tel: 912-487-2288 Fax: 912-487-2083
Contact information for business:
235 NORTH CHURCH STREET HOMERVILLE, GA 31634 US
Tel: 912-487-2288 Fax: 912-487-2083
Tel: 912-487-2288 Fax: 912-487-2083
Registration Information:
NPI: 1295894509
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | GA | 5479 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 00686485A | GA | 05 |
