Provider Demographics
NPI:1730312554
Name:CRAWFORD, BRUCE S (DC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:S
Last Name:CRAWFORD
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 1:2825 N LOS FELICES RD
Mailing Address - Street 2:#208
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-1981
Mailing Address - Country:US
Mailing Address - Phone:760-964-0179
Mailing Address - Fax:
Practice Address - Street 1:2825 N LOS FELICES RD
Practice Address - Street 2:#208
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-1981
Practice Address - Country:US
Practice Address - Phone:760-964-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor