Provider Demographics
NPI:1578638912
Name:NED J. CROWLEY P.C.
Entity Type:Organization
Organization Name:NED J. CROWLEY P.C.
Other - Org Name:CROWLEY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NED
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-453-9229
Mailing Address - Street 1:111 MARKET STREET SUITE 1C
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987
Mailing Address - Country:US
Mailing Address - Phone:507-453-9229
Mailing Address - Fax:507-453-0227
Practice Address - Street 1:111 MARKET STREET SUITE 1C
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987
Practice Address - Country:US
Practice Address - Phone:507-453-9229
Practice Address - Fax:507-453-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1978111N00000X
WI1832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
231139OtherCCMI
MN4C358CROtherBCBS
MN4C358CROtherBCBS
T39864Medicare UPIN