Provider Demographics
NPI:1609095785
Name:CROUSE, JONATHAN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JAMES
Last Name:CROUSE
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 1:8478 RT 949
Mailing Address - Street 2:PO BOX 24
Mailing Address - City:SIGEL
Mailing Address - State:PA
Mailing Address - Zip Code:15860
Mailing Address - Country:US
Mailing Address - Phone:814-752-2218
Mailing Address - Fax:814-752-2218
Practice Address - Street 1:8478 RTE 949
Practice Address - Street 2:
Practice Address - City:SIGEL
Practice Address - State:PA
Practice Address - Zip Code:15860
Practice Address - Country:US
Practice Address - Phone:814-752-2218
Practice Address - Fax:814-752-2218
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008800111N00000X
PAAJ008669111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1690585OtherHIGHMARK BLUE CROSS BLUE