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General NPI Number Information
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NPI Number | 1700133394
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Entity Type | Individual
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Provider Name | DR. CANDICE ALISHA CRAWFORD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 01/12/2025
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Provider Practice Location Address
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Address Line | 6221 SHALLOWFORD RD STE 102
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1972
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Country | US
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Telephone | 423-541-9455
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Fax |
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Provider Business Mailing Address
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Address Line | 6221 SHALLOWFORD RD STE 102
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1972
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Country | US
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Telephone | 404-839-4566
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Fax |
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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 | CHIRO009041
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License Number State | GA
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