Provider Demographics
NPI:1972649929
Name:CROWLEY, BRETT LOUIS (DC)
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:LOUIS
Last Name:CROWLEY
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 1:6785 W RUSSELL RD STE 140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1862
Mailing Address - Country:US
Mailing Address - Phone:702-646-8400
Mailing Address - Fax:702-920-8846
Practice Address - Street 1:6785 W RUSSELL RD STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1862
Practice Address - Country:US
Practice Address - Phone:702-646-8400
Practice Address - Fax:702-920-8846
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU92309Medicare UPIN
NV39646Medicare ID - Type Unspecified