Provider Demographics
NPI:1598858557
Name:CRABB, RITSUKO (DC)
Entity Type:Individual
Prefix:DR
First Name:RITSUKO
Middle Name:
Last Name:CRABB
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 1:3515 SPRING ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2100
Mailing Address - Country:US
Mailing Address - Phone:563-386-4130
Mailing Address - Fax:
Practice Address - Street 1:3515 SPRING ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2100
Practice Address - Country:US
Practice Address - Phone:563-386-4130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAU02363Medicare UPIN
IA03173Medicare ID - Type Unspecified