Healthcare Provider Details

I. General information

NPI: 1982645164
Provider Name (Legal Business Name): MICHAEL EUGENE CROWLEY D. C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 1ST AVE N
HUMBOLDT IA
50548-1713
US

IV. Provider business mailing address

611 1ST AVE N P. O. BOX 56
HUMBOLDT IA
50548-1713
US

V. Phone/Fax

Practice location:
  • Phone: 515-332-5414
  • Fax: 515-332-5415
Mailing address:
  • Phone: 515-332-5414
  • Fax: 515-332-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberA05718
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: