Provider Demographics
NPI:1265547400
Name:CROWLEY, KEVIN E (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:E
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 1:7579 ALEXANDRIA PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-1031
Mailing Address - Country:US
Mailing Address - Phone:859-635-6666
Mailing Address - Fax:859-635-6607
Practice Address - Street 1:7579 ALEXANDRIA PK
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001
Practice Address - Country:US
Practice Address - Phone:859-635-6666
Practice Address - Fax:859-635-6607
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY300180548OtherTAX ID
KY85000883Medicaid
KY300180548OtherTAX ID
KY85000883Medicaid