Healthcare Provider Details

I. General information

NPI: 1588712038
Provider Name (Legal Business Name): PATRICK CRAIG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8481 FISHERS CENTER DR
FISHERS IN
46038-2318
US

IV. Provider business mailing address

8481 FISHERS CENTER DR
FISHERS IN
46038-2318
US

V. Phone/Fax

Practice location:
  • Phone: 317-576-9620
  • Fax: 317-576-9621
Mailing address:
  • Phone: 317-770-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001844A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: