Provider Demographics
NPI:1659601698
Name:CROWDER, JAMES JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CROWDER
Suffix:JR
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 1:11 E JOLIET ST
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2010
Mailing Address - Country:US
Mailing Address - Phone:219-864-8284
Mailing Address - Fax:219-864-8280
Practice Address - Street 1:11 E JOLIET ST
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2010
Practice Address - Country:US
Practice Address - Phone:219-864-8284
Practice Address - Fax:219-864-8280
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002491A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor