Crystal Chiropractic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301008438 Issued in MI

Legal business name

CRYSTAL CHIROPRACTIC, P.C.

Practice address

1374 Commercial Ave
Suite 3
Crystal Falls, MI 49920-1085

Phone

(906) 875-3215

Fax

(906) 874-3215

NPI assigned

Jun 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Larry Jay Loewen Jr., D.C.NPI 1609095496

Title

President

Phone

(906) 875-3215

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry Jay Loewen Jr., D.C

  • Chiropractor
  • Crystal Falls, MI
  • NPI 1609095496
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1306040746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 COMMERCIAL AVE",
            "address_2": "SUITE 3",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201085",
            "telephone_number": "906-875-3215",
            "fax_number": "906-874-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 COMMERCIAL AVE",
            "address_2": "SUITE 3",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201085",
            "telephone_number": "906-875-3215",
            "fax_number": "906-874-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "LOEWEN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-875-3215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Crystal Falls, MI
• Providers in Crystal Falls, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.