MEDICARE: ARTHUR EUGENE CRAGO 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	0104001355	VA

General Provider Information

NPI Number	:	1437202025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR EUGENE CRAGO D.C.

Provider Business Mailing Address
First Line	:	4224 HOLLAND RD
Second Line	:	SUITE 110
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1900
Country	:	US
Telephone Number	:	757-486-4772
Fax Number	:	757-486-6511

Provider Business Practice Location Address
First Line	:	4224 HOLLAND RD
Second Line	:	SUITE 110
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1900
Country	:	US
Telephone Number	:	757-486-4772
Fax Number	:	757-486-6511

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	11/25/2008

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