Provider Demographics
NPI:1356421150
Name:CRAWFORD, ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W MONTCASTLE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-5827
Mailing Address - Country:US
Mailing Address - Phone:336-379-7871
Mailing Address - Fax:
Practice Address - Street 1:CRAWFORD CHIROPRACTIC CENTER
Practice Address - Street 2:1109 SUMMIT AVE
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-373-8344
Practice Address - Fax:336-217-8437
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2154111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890820LMedicaid
NC2451295Medicare ID - Type Unspecified
NCU65686Medicare UPIN