MEDICARE: DR. CRAIG MARLOW D.C.

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
1	111N00000X	Chiropractor	CHIR006557	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	90-1028536	OTHER	GA	TAX ID

General Provider Information

NPI Number	:	1396838256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG MARLOW D.C.

Provider Business Mailing Address
First Line	:	1716 CLEVELAND HWY
Second Line	:	SUITE 700
City	:	DALTON
State	:	GA
Zip	:	30721-2314
Country	:	US
Telephone Number	:	706-529-9355
Fax Number	:	706-529-7735

Provider Business Practice Location Address
First Line	:	1716 CLEVELAND HWY
Second Line	:	SUITE 700
City	:	DALTON
State	:	GA
Zip	:	30721-2314
Country	:	US
Telephone Number	:	706-529-9355
Fax Number	:	706-529-7735

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	01/10/2014

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