Provider Demographics
NPI:1558199885
Name:CRUX CHIROPRACTIC
Entity type:Organization
Organization Name:CRUX CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:EVANA
Authorized Official - Middle Name:WATFA-ZINA
Authorized Official - Last Name:MAKHOUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-287-3123
Mailing Address - Street 1:2433 BROAD ST # A
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-2910
Mailing Address - Country:US
Mailing Address - Phone:423-287-3123
Mailing Address - Fax:
Practice Address - Street 1:2433 BROAD ST # A
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-2910
Practice Address - Country:US
Practice Address - Phone:423-287-3123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty