Provider Demographics
NPI:1982645164
Name:CROWLEY, MICHAEL EUGENE (D C)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 1ST AVE N
Mailing Address - Street 2:P. O. BOX 56
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-1713
Mailing Address - Country:US
Mailing Address - Phone:515-332-5414
Mailing Address - Fax:515-332-5415
Practice Address - Street 1:611 1ST AVE N
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:IA
Practice Address - Zip Code:50548-1713
Practice Address - Country:US
Practice Address - Phone:515-332-5414
Practice Address - Fax:515-332-5415
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0279810Medicaid
IAU44031Medicare UPIN
IAI7201Medicare ID - Type Unspecified