Provider Demographics
NPI:1821694100
Name:THIS RIVER LLC
Entity Type:Organization
Organization Name:THIS RIVER LLC
Other - Org Name:CRAWFORDVILLE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BATTEN-LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-926-1227
Mailing Address - Street 1:2887 CRAWFORDVILLE HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-2381
Mailing Address - Country:US
Mailing Address - Phone:850-926-1227
Mailing Address - Fax:850-926-6550
Practice Address - Street 1:2887 CRAWFORDVILLE HWY STE 1
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2381
Practice Address - Country:US
Practice Address - Phone:850-926-1227
Practice Address - Fax:850-926-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty