Provider Demographics
NPI:1770632085
Name:DR. KEITH H. CROWE, P.C.
Entity type:Organization
Organization Name:DR. KEITH H. CROWE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:770-507-5226
Mailing Address - Street 1:505 CORPORATE CENTER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7255
Mailing Address - Country:US
Mailing Address - Phone:770-507-5226
Mailing Address - Fax:770-507-5767
Practice Address - Street 1:505 CORPORATE CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7255
Practice Address - Country:US
Practice Address - Phone:770-507-5226
Practice Address - Fax:770-507-5767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty