Provider Demographics
NPI:1467633503
Name:KEVIN E CROWLEY DC PSC
Entity Type:Organization
Organization Name:KEVIN E CROWLEY DC PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-635-6666
Mailing Address - Street 1:7579 ALEXANDRIA PK
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001
Mailing Address - Country:US
Mailing Address - Phone:859-635-6666
Mailing Address - Fax:859-635-6607
Practice Address - Street 1:7579 ALEXANDRIA PK
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1031
Practice Address - Country:US
Practice Address - Phone:859-635-6666
Practice Address - Fax:859-635-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7773Medicare PIN
4900570001Medicare NSC