Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2547 | CO |
NPI | 1558474346 |
---|---|
Provider Name | Dr. Greg Lee Crawford |
First Address | Fort Collins, CO 80525-1115 |
Second Address | Fort Collins, CO 80525-1115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T60651 | (02) | CO |