Provider Demographics
NPI:1821843665
Name:CRABTREE, DALTON DWAYNE (DC)
Entity type:Individual
Prefix:
First Name:DALTON
Middle Name:DWAYNE
Last Name:CRABTREE
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 1:1500 DARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-2057
Mailing Address - Country:US
Mailing Address - Phone:765-362-1500
Mailing Address - Fax:765-361-8919
Practice Address - Street 1:1500 DARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-2057
Practice Address - Country:US
Practice Address - Phone:765-362-1500
Practice Address - Fax:765-361-8919
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003422A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor