Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2014000792 | MO |
NPI | 1003239914 |
---|---|
Provider Name | Dr. Christopher Michael James Crawford |
First Address | Cape Girardeau, MO 63701-4904 |
Second Address | Cape Girardeau, MO 63703-5903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2014 |
Last Update Date | 26/08/2019 |