Organization
CHARLES F CRANDALL DC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES F CRANDALL DC (PRESIDENT)
(727) 447-6779
Entity
Organization
Contact information
Practice address
1501 LAKEVIEW RD, CLEARWATER, FL 33756-3647
(727) 447-6779
(727) 462-2634
Mailing address
1501 LAKEVIEW RD, CLEARWATER, FL 33756-3647
(727) 447-6779
(727) 462-2634
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7804
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010609000
—
FL
01
—
1148135
AMERICAN SPECIALTY HEALTH
FL
01
—
55998
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/14/2015
Last updated
01/14/2015
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