Provider Demographics
NPI:1356184410
Name:CRIMSON CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:CRIMSON CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-345-2009
Mailing Address - Street 1:2302 MCFARLAND BLVD E
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5802
Mailing Address - Country:US
Mailing Address - Phone:205-345-2009
Mailing Address - Fax:205-345-2039
Practice Address - Street 1:2302 MCFARLAND BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5802
Practice Address - Country:US
Practice Address - Phone:205-345-2009
Practice Address - Fax:205-345-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center