MEDICARE: CRAVIOTTO CHIROPRACTIC CORP.

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	DC17657	CA

General Provider Information

NPI Number	:	1861502700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAVIOTTO CHIROPRACTIC CORP.

Provider Business Mailing Address
First Line	:	PO BOX 883
Second Line	:
City	:	LOS OLIVOS
State	:	CA
Zip	:	93441-0883
Country	:	US
Telephone Number	:	805-688-5545
Fax Number	:	805-688-5676

Provider Business Practice Location Address
First Line	:	2922 DE LA VINA ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-3372
Country	:	US
Telephone Number	:	805-563-0007
Fax Number	:	805-682-7075

Authorized Official
Title or Position	:	SECRETARY OF THE CORPORATION
Name	:	DR. LORI ALLISON CRAVIOTTO
Credential	:	DC
Telephone Number	:	805-688-5545

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/21/2022

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