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General NPI Number Information
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NPI Number | 1275248718
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Entity Type | Organization
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Legal Business Name | CRUM CHIROPRACTIC CORP
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 435 MAIN ST.
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City | ETNA
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State | CA
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Zip | 96027
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Country | US
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Telephone | 530-467-5600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860
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City | ETNA
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State | CA
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Zip | 96027-0860
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Country | US
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Telephone | 530-461-5600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH CRUM
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Credential | DC
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Telephone | 530-966-0332
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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 |
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License Number State |
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