Provider Demographics
NPI:1447467139
Name:CROWLEY, NEIL JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:JOSEPH
Last Name:CROWLEY
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 1:35 REGENCY WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3423
Mailing Address - Country:US
Mailing Address - Phone:775-324-5453
Mailing Address - Fax:775-324-6011
Practice Address - Street 1:35 REGENCY WAY
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3423
Practice Address - Country:US
Practice Address - Phone:775-324-5453
Practice Address - Fax:775-324-6011
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU71502Medicare UPIN
NVV31225Medicare ID - Type Unspecified