Provider Demographics
NPI:1750496972
Name:CRABBE, ALICIA M (DC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:CRABBE
Suffix:
Gender:F
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:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-0003
Mailing Address - Country:US
Mailing Address - Phone:508-748-6633
Mailing Address - Fax:508-748-6649
Practice Address - Street 1:238 WAREHAM RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:MA
Practice Address - Zip Code:02738-1166
Practice Address - Country:US
Practice Address - Phone:508-748-6633
Practice Address - Fax:508-748-6649
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2077111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350146OtherHPHC PROVIDER ID
8288248OtherCIGNA PROVIDER ID
Y36455OtherBCBS OF MA PROVIDER ID
646519OtherACN PROVIDER ID
0000000254415OtherBMC HEALTHNET PROVIDER ID
MA1610864Medicaid
2553436OtherAETNA PROVIDER ID
44-00641OtherUHC PROVIDER ID
002077OtherTUFTS PROVIDER ID
Y36455OtherBCBS OF MA PROVIDER ID
350146OtherHPHC PROVIDER ID