Provider Demographics
NPI:1437292133
Name:CRUMPLER, ALAN JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JAY
Last Name:CRUMPLER
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 1:8520 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2413
Mailing Address - Country:US
Mailing Address - Phone:770-949-7722
Mailing Address - Fax:770-949-2225
Practice Address - Street 1:8520 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2413
Practice Address - Country:US
Practice Address - Phone:770-949-7722
Practice Address - Fax:770-949-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIROO2565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor