Provider Demographics
NPI:1811048770
Name:CROWLEY CHIROPRACTIC PC
Entity type:Organization
Organization Name:CROWLEY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:989-856-4187
Mailing Address - Street 1:6827 MICHIGAN ST
Mailing Address - Street 2:PO BOX 1042
Mailing Address - City:CASEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48725-9542
Mailing Address - Country:US
Mailing Address - Phone:989-856-4187
Mailing Address - Fax:989-856-2118
Practice Address - Street 1:6827 MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:CASEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48725-9542
Practice Address - Country:US
Practice Address - Phone:989-856-4187
Practice Address - Fax:989-856-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHV008811111N00000X
MIEY009186111N00000X
MIJC006772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1946881Medicaid
MI4917480Medicaid
MI1366410458OtherNPI DR CROWLEY
MI1437264934OtherNPI DR VOLLMAR
MI1023040847OtherINDIVDUAL NPI DR YEAGER
MI4899758Medicaid
MI4899758Medicaid
MIT33753Medicare UPIN
MI1366410458OtherNPI DR CROWLEY
MI4917480Medicaid