Provider Demographics
NPI:1396140034
Name:CROWELL, MARK EDWIN (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWIN
Last Name:CROWELL
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 1:1556 W MCEWEN DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1806
Mailing Address - Country:US
Mailing Address - Phone:615-905-8783
Mailing Address - Fax:615-905-8786
Practice Address - Street 1:1556 W MCEWEN DR
Practice Address - Street 2:SUITE 130
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1806
Practice Address - Country:US
Practice Address - Phone:615-905-8783
Practice Address - Fax:615-905-8786
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor