Healthcare Provider Details

I. General information

NPI: 1548359631
Provider Name (Legal Business Name): CRAIG FOSTER HARTMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 2ND AVE S
SAINT JAMES MN
56081-1737
US

IV. Provider business mailing address

502 2ND AVE S
SAINT JAMES MN
56081-1737
US

V. Phone/Fax

Practice location:
  • Phone: 507-942-2002
  • Fax: 507-639-6571
Mailing address:
  • Phone: 507-942-2002
  • Fax: 507-639-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2711
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: