Provider Demographics
NPI:1558051938
Name:CROSS, EMILY JOSEPHINE (DC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JOSEPHINE
Last Name:CROSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11023 GATEWOOD DR STE 101
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4945
Mailing Address - Country:US
Mailing Address - Phone:941-744-1585
Mailing Address - Fax:941-744-1572
Practice Address - Street 1:3090 FRUITVILLE COMMONS BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-2729
Practice Address - Country:US
Practice Address - Phone:941-724-8451
Practice Address - Fax:941-724-8453
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor