Provider Demographics
NPI:1639931918
Name:CROSS CHIROPRACTIC INC
Entity Type:Organization
Organization Name:CROSS CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-422-7677
Mailing Address - Street 1:38345 30TH ST E STE B3
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4981
Mailing Address - Country:US
Mailing Address - Phone:661-422-7677
Mailing Address - Fax:
Practice Address - Street 1:38345 30TH ST E STE B3
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4981
Practice Address - Country:US
Practice Address - Phone:661-422-7677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty