Provider Demographics
NPI:1417240177
Name:CROSBY CHIROPRACTIC CENTER, INC
Entity Type:Organization
Organization Name:CROSBY CHIROPRACTIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO - CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BING
Authorized Official - Middle Name:G
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-969-3121
Mailing Address - Street 1:4508 OUTER LOOP
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-3857
Mailing Address - Country:US
Mailing Address - Phone:502-969-3121
Mailing Address - Fax:502-969-4570
Practice Address - Street 1:4508 OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3857
Practice Address - Country:US
Practice Address - Phone:502-969-3121
Practice Address - Fax:502-969-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty