Provider Demographics
NPI:1801046743
Name:CRAWFORD, BRICE EVINS (DC)
Entity type:Individual
Prefix:DR
First Name:BRICE
Middle Name:EVINS
Last Name:CRAWFORD
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 1:3016 N PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-3828
Mailing Address - Country:US
Mailing Address - Phone:575-218-3214
Mailing Address - Fax:575-935-3222
Practice Address - Street 1:3016 N PRINCE ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-3828
Practice Address - Country:US
Practice Address - Phone:575-218-3214
Practice Address - Fax:575-935-3222
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1194961706OtherCRAWFORD FAMILY CHIROPRACTIC
NM1801046743OtherBRICE EVINS CRAWFORD
NMNMB2271Medicare UPIN