Provider Demographics
NPI:1639328453
Name:CRAWFORD CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CRAWFORD CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:318-412-9007
Mailing Address - Street 1:6769 KINLOCH ST
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-2619
Mailing Address - Country:US
Mailing Address - Phone:318-412-9007
Mailing Address - Fax:318-412-9050
Practice Address - Street 1:6769 KINLOCH ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2619
Practice Address - Country:US
Practice Address - Phone:318-412-9007
Practice Address - Fax:318-412-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C794Medicare UPIN