Provider Demographics
NPI:1902941339
Name:BRIAN CRUME DC A CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:BRIAN CRUME DC A CHIROPRACTIC CORPORATION
Other - Org Name:CONTINENTAL ST CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CRUME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-244-4772
Mailing Address - Street 1:1756 CONTINENTAL ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1240
Mailing Address - Country:US
Mailing Address - Phone:530-244-4772
Mailing Address - Fax:530-244-1118
Practice Address - Street 1:1756 CONTINENTAL ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1240
Practice Address - Country:US
Practice Address - Phone:530-244-4772
Practice Address - Fax:530-244-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18074111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty