Provider Demographics
NPI:1336711142
Name:CRONK CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:CRONK CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-931-1339
Mailing Address - Street 1:4817 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-5028
Mailing Address - Country:US
Mailing Address - Phone:509-900-6555
Mailing Address - Fax:509-900-6555
Practice Address - Street 1:4817 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-5028
Practice Address - Country:US
Practice Address - Phone:509-900-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty