MEDICARE: CROSBY CHIROPRACTIC CENTER

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	3133R	KY

General Provider Information

NPI Number	:	1992844831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSBY CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	4508 OUTER LOOP
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40219-3857
Country	:	US
Telephone Number	:	502-969-3121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4508 OUTER LOOP
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40219-3857
Country	:	US
Telephone Number	:	502-969-3121
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. BING G CROSBY
Credential	:	D.C.
Telephone Number	:	502-969-3121

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	08/22/2020

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