Provider Demographics
NPI:1992844831
Name:CROSBY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:CROSBY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BING
Authorized Official - Middle Name:G
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-969-3121
Mailing Address - Street 1:4508 OUTER LOOP
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-3857
Mailing Address - Country:US
Mailing Address - Phone:502-969-3121
Mailing Address - Fax:
Practice Address - Street 1:4508 OUTER LOOP
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3857
Practice Address - Country:US
Practice Address - Phone:502-969-3121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3133R111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty