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DR. IRA JEREMY CRAWFORD DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1225119837

Individual Registrant:
DR. IRA JEREMY CRAWFORD DC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1177 S MAIN ST  SMITHFIELD, UT 84335-6764 US
Tel: 435-563-6887  Fax: 435-535-0769

Contact information for business:
1177 S MAIN ST  SMITHFIELD, UT 84335-6764 US
Tel: 435-563-6887  Fax: --

Registration Information:
NPI: 1225119837
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
UT368408-1202

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
8062848ID05
MEDICARE PTAN000012535UT01




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