Provider Demographics
NPI:1548527575
Name:CROWLEY, BRIAN PATRICK (L AC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PATRICK
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CENTENNIAL STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20677
Mailing Address - Country:US
Mailing Address - Phone:301-932-6125
Mailing Address - Fax:
Practice Address - Street 1:203 CENTENNIAL ST.
Practice Address - Street 2:SUITE 107
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646
Practice Address - Country:US
Practice Address - Phone:301-932-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDUO1976171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist