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General NPI Number Information
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NPI Number | 1922291772
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Entity Type | Organization
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Legal Business Name | CROFTS INC
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 08/24/2007
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Provider Practice Location Address
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Address Line | 14602 NE 4TH PLAIN STE K
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City | VANCOUVER
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State | WA
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Zip | 98682
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Country | US
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Telephone | 360-256-0200
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Fax | 360-256-0300
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Provider Business Mailing Address
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Address Line | 14602 NE 4TH PLAIN STE K
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City | VANCOUVER
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State | WA
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Zip | 98682
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Country | US
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Telephone | 360-256-0200
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Fax | 360-256-0300
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Authorized Official
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Title or Position | DC
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Name | BLAKE E CROFTS
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Credential | DC
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Telephone | 360-256-0200
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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 | CH00033808
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License Number State | WA
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