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NPI Code Detail

MEDICARE: CRAIG ALAN DAVIS

MEDICARE: CRAIG ALAN DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1184815573
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRAIG ALAN DAVIS
Provider Business Mailing Address
First Line : 1850 MCCULLOCH BLVD N STE C5
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5798
Country : US
Telephone Number : 928-855-1220
Fax Number : 928-855-1221
Provider Business Practice Location Address
First Line : 1850 MCCULLOCH BLVD N STE C5
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5798
Country : US
Telephone Number : 928-855-1220
Fax Number : 928-855-1221
Authorized Official
Title or Position : OWNER
Name : MR. CRAIG ALAN DAVIS
Credential : OWNER
Telephone Number : 928-855-1220
Provider Enumeration Date : 08/09/2007
Last Update Date : 05/04/2012

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Directions to “CRAIG ALAN DAVIS ” Practice Location

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