Provider Demographics
NPI:1689410763
Name:OFOEGBU, CRYSTAL NKIRUKA (DC)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:NKIRUKA
Last Name:OFOEGBU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 W HIGHWAY 82
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240
Mailing Address - Country:US
Mailing Address - Phone:940-665-6060
Mailing Address - Fax:
Practice Address - Street 1:4322 W HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240
Practice Address - Country:US
Practice Address - Phone:940-665-6060
Practice Address - Fax:940-665-6065
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor