Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3087 | OH |
NPI | 1003976812 |
---|---|
Provider Name | Dr. Jeffrey Allen Crawford |
First Address | Oregon, OH 43616-3187 |
Second Address | Oregon, OH 43616-3187 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 06/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2261467 | (05) | OH |
U84273 | (02) | OH |