Provider Demographics
NPI:1851845895
Name:CRAWFORD, DILLON QUAYED (DC)
Entity Type:Individual
Prefix:DR
First Name:DILLON
Middle Name:QUAYED
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 1:1803 SW REGIONAL AIRPORT BLVD
Mailing Address - Street 2:ST. 9
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7755
Mailing Address - Country:US
Mailing Address - Phone:479-319-6211
Mailing Address - Fax:
Practice Address - Street 1:1803 SW REGIONAL AIRPORT BLVD
Practice Address - Street 2:ST. 9
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7755
Practice Address - Country:US
Practice Address - Phone:479-319-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor