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Individual

DR. MARK D CROUCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
219 MCLAWS CIR, WILLIAMSBURG, VA 23185-5649
(757) 259-1122
(757) 259-1123
Mailing address
219 MCLAWS CIR, WILLIAMSBURG, VA 23185-5649
(757) 259-1122
(757) 259-1123

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
007252
NY
111NX0800X
Orthopedic Chiropractor
Primary
1199
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
195038
ANTHEM BLUE CROSS
VA
01
7967114001
CIGNA
VA
Enumeration date
06/07/2006
Last updated
11/10/2010
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