Provider Demographics
NPI:1669439022
Name:CROSS, NEAL ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:ANTHONY
Last Name:CROSS
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 1:430 N DOBSON RD
Mailing Address - Street 2:STE 116
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-5276
Mailing Address - Country:US
Mailing Address - Phone:480-969-9775
Mailing Address - Fax:480-969-9506
Practice Address - Street 1:715 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2569
Practice Address - Country:US
Practice Address - Phone:712-792-4600
Practice Address - Fax:712-792-7775
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06537111N00000X
AZ8517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2267195Medicaid
IAI12161Medicare ID - Type UnspecifiedMEDICARE
IA2267195Medicaid