Healthcare Provider Details

I. General information

NPI: 1205104916
Provider Name (Legal Business Name): STEVEN R KRAFT DC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N FERRY ST STE D
GRAND HAVEN MI
49417-1166
US

IV. Provider business mailing address

300 N FERRY ST STE D
GRAND HAVEN MI
49417-1166
US

V. Phone/Fax

Practice location:
  • Phone: 586-337-3178
  • Fax:
Mailing address:
  • Phone: 586-337-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2301007252
License Number StateMI

VIII. Authorized Official

Name: DR. STEVEN ROBERT KRAFT
Title or Position: OWNER
Credential: D.C.
Phone: 586-337-3178