Provider Demographics
NPI:1942496401
Name:PAUL CROW DC LLC
Entity Type:Organization
Organization Name:PAUL CROW DC LLC
Other - Org Name:CROW CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-906-2055
Mailing Address - Street 1:255 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-4155
Mailing Address - Country:US
Mailing Address - Phone:931-906-2055
Mailing Address - Fax:931-906-2172
Practice Address - Street 1:255 DOVER RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4155
Practice Address - Country:US
Practice Address - Phone:931-906-2055
Practice Address - Fax:931-906-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3971257OtherMEDICARE
TNU97921Medicare UPIN
TN3723215Medicare PIN