Provider Demographics
NPI:1174319990
Name:THOMAS WILLIAM CRUMBLEY
Entity type:Organization
Organization Name:THOMAS WILLIAM CRUMBLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:CRUMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-431-4715
Mailing Address - Street 1:5720 NEWBERRY POINT DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-2754
Mailing Address - Country:US
Mailing Address - Phone:404-431-4715
Mailing Address - Fax:
Practice Address - Street 1:8600 PENDERGRASS RD
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-2300
Practice Address - Country:US
Practice Address - Phone:706-929-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty