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General NPI Number Information
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NPI Number | 1891938346
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Entity Type | Organization
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Legal Business Name | CREWS CHIROPRACTIC PA
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 1365 BEVILLE RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-1529
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Country | US
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Telephone | 386-846-3467
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Fax | 386-269-1209
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Provider Business Mailing Address
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Address Line | 1365 BEVILLE RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-1529
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Country | US
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Telephone | 386-846-3467
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Fax | 386-269-1209
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | DR. BRANDON L CREWS
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Credential | D.C.
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Telephone | 386-492-7963
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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 | CH9585
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License Number State | FL
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