Provider Demographics
NPI:1861562936
Name:CRAWFORD, MICHELLE DAWN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DAWN
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903
Mailing Address - Country:US
Mailing Address - Phone:325-659-1491
Mailing Address - Fax:325-657-0637
Practice Address - Street 1:107 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903
Practice Address - Country:US
Practice Address - Phone:325-659-1491
Practice Address - Fax:325-657-0637
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127092OtherCHIPS
U1166Medicare UPIN
TX609088Medicare ID - Type Unspecified