Provider Demographics
NPI:1811000334
Name:CROTHERS, ANTHONY M (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:M
Last Name:CROTHERS
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 1:5330 SW 186TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1414
Mailing Address - Country:US
Mailing Address - Phone:954-384-0245
Mailing Address - Fax:954-384-8241
Practice Address - Street 1:5330 SW 186TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33332-1414
Practice Address - Country:US
Practice Address - Phone:954-384-0245
Practice Address - Fax:954-384-8241
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22961Medicare UPIN
FL22961Medicare ID - Type Unspecified