Individual
DR. IRA JEREMY CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1177 S MAIN ST, SMITHFIELD, UT 84335-6764
(435) 563-6887
(435) 535-0769
Mailing address
1177 S MAIN ST, SMITHFIELD, UT 84335-6764
(435) 563-6887
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
368408-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000012535
MEDICARE PTAN
UT
05
—
8062848
—
ID
Enumeration date
10/18/2006
Last updated
10/22/2015
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