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General NPI Number Information
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NPI Number | 1922439173
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Entity Type | Organization
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Legal Business Name | DR CROWES LIGHTHOUSE CHIROPRACTIC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 1616 LUDINGTON ST
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City | ESCANABA
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State | MI
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Zip | 49829-2840
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Country | US
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Telephone | 906-786-0400
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Fax | 906-786-0400
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Provider Business Mailing Address
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Address Line | 1616 LUDINGTON ST
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City | ESCANABA
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State | MI
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Zip | 49829-2840
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Country | US
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Telephone | 906-786-0400
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Fax | 906-786-0400
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PAUL RAYMOND CROWE
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Credential | D.C
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Telephone | 906-786-0400
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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 | 2301008769
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License Number State | MI
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