Provider Demographics
NPI:1417605544
Name:CROSSLEY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:CROSSLEY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-634-2225
Mailing Address - Street 1:9625 BLACK MOUNTAIN RD STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4598
Mailing Address - Country:US
Mailing Address - Phone:858-634-2225
Mailing Address - Fax:
Practice Address - Street 1:9625 BLACK MOUNTAIN RD STE 208
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4598
Practice Address - Country:US
Practice Address - Phone:858-634-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty