Provider Demographics
NPI:1699969394
Name:CROWLEY, JANICE K (DC)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:K
Last Name:CROWLEY
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 1:3450 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-5335
Mailing Address - Country:US
Mailing Address - Phone:651-777-1705
Mailing Address - Fax:
Practice Address - Street 1:3450 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-5335
Practice Address - Country:US
Practice Address - Phone:651-777-1705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor