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General NPI Number Information
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NPI Number | 1073510160
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Entity Type | Individual
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Provider Name | CARL RODNEY CREWS JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 915 OLIVE ST
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City | SHREVEPORT
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State | LA
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Zip | 71104-2103
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Country | US
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Telephone | 318-220-7688
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Fax | 318-220-7690
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Provider Business Mailing Address
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Address Line | 915 OLIVE ST
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City | SHREVEPORT
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State | LA
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Zip | 71104-2103
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Country | US
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Telephone | 318-220-7688
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Fax | 318-220-7690
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1343
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9556
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License Number State | TX
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