Organization
PEGGY KISER CROUCH DC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY KISER CROUCH DC (CHIROPRACTIC PHYSICIAN)
(304) 344-9077
Entity
Organization
Contact information
Practice address
308 PATRICK STREET PLZ, CHARLESTON, WV 25387-2439
(304) 344-9077
(304) 344-3587
Mailing address
308 PATRICK STREET PLZ, CHARLESTON, WV 25387-2439
(304) 344-9077
(304) 344-3587
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
383
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001708536
MSBCBS
WV
01
—
43157157
AETNA
—
Enumeration date
09/01/2006
Last updated
04/25/2012
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