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General NPI Number Information
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NPI Number | 1073738522
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Entity Type | Organization
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Legal Business Name | CROWLEY CHIROPRACTIC CLINIC, P.C.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 597 PALISADE DR
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City | BRUNSWICK
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State | GA
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Zip | 31523-8208
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Country | US
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Telephone | 912-265-2129
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Fax | 912-265-2605
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Provider Business Mailing Address
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Address Line | 597 PALISADE DR
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City | BRUNSWICK
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State | GA
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Zip | 31523-8208
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Country | US
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Telephone | 912-265-2129
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Fax | 912-265-2605
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TINA LOUISE CROWLEY
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Credential | D. C.
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Telephone | 912-265-2129
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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 | CHIR006507
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License Number State | GA
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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 | CHIR005978
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License Number State | GA
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