Healthcare Provider Details
I. General information
NPI: 1669439022
Provider Name (Legal Business Name): NEAL ANTHONY CROSS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/28/2006
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
715 N CLARK ST
CARROLL IA
51401-2569
US
IV. Provider business mailing address
430 N DOBSON RD STE 116
MESA AZ
85201-5276
US
V. Phone/Fax
- Phone: 712-792-4600
- Fax: 712-792-7775
- Phone: 480-969-9775
- Fax: 480-969-9506
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 06537 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 8517 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: