Provider Demographics
NPI:1982612248
Name:CRC CHIROPRACTIC,L.L.C.
Entity Type:Organization
Organization Name:CRC CHIROPRACTIC,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:623-849-9416
Mailing Address - Street 1:4619 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5203
Mailing Address - Country:US
Mailing Address - Phone:602-956-0111
Mailing Address - Fax:602-956-0720
Practice Address - Street 1:2330 N 75TH AVE
Practice Address - Street 2:STE 104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-1200
Practice Address - Country:US
Practice Address - Phone:623-849-9416
Practice Address - Fax:623-849-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty