Individual
MATTHEW CRILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12740 SPRUCE TREE WAY, RALEIGH, NC 27614-8295
(919) 570-6160
(919) 570-6170
Mailing address
12740 SPRUCE TREE WAY, RALEIGH, NC 27614-8295
(919) 570-6160
(919) 570-6170
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2846
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201U
BCBS GROUP NUMBER
NC
01
—
0846V
BCBS INDIVIDUAL NUMBER
NC
05
—
790201U
—
NC
05
—
890846V
—
NC
Enumeration date
12/27/2005
Last updated
07/09/2007
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