Provider Demographics
NPI:1023171329
Name:SMITH, NICHOLAS JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JAMES
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 1:320 E 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4027
Mailing Address - Country:US
Mailing Address - Phone:406-461-7420
Mailing Address - Fax:
Practice Address - Street 1:320 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4027
Practice Address - Country:US
Practice Address - Phone:406-443-3965
Practice Address - Fax:406-443-3964
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41573OtherBLUE CROSS BLUE SHIELD