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General NPI Number Information
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NPI Number | 1235688383
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Entity Type | Organization
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Legal Business Name | CRAFT CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 111 S BROADWAY ST
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-9167
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Country | US
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Telephone | 269-205-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 111 S BROADWAY ST
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-9167
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Country | US
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Telephone | 269-205-2300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENNIS CRAFT
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Credential | D.C.
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Telephone | 517-543-1115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301005297
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License Number State | MI
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