MEDICARE: CRANDELL CHIROPRACTIC CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	26701	CA

General Provider Information

NPI Number	:	1659392777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRANDELL CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	6530 HIGHWAY 9
Second Line	:
City	:	FELTON
State	:	CA
Zip	:	95018-9757
Country	:	US
Telephone Number	:	831-335-9300
Fax Number	:	831-335-9304

Provider Business Practice Location Address
First Line	:	6530 HIGHWAY 9
Second Line	:
City	:	FELTON
State	:	CA
Zip	:	95018-9757
Country	:	US
Telephone Number	:	831-335-9300
Fax Number	:	831-335-9304

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KERRI ANN CRANDELL
Credential	:	DC
Telephone Number	:	831-335-9300

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	01/19/2011

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Directions to “CRANDELL CHIROPRACTIC CORPORATION ” Practice Location

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