Provider Demographics
NPI:1174721955
Name:CRAFT CHIROPRACTIC CENTER, PC
Entity type:Organization
Organization Name:CRAFT CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:517-487-2225
Mailing Address - Street 1:1914 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-2829
Mailing Address - Country:US
Mailing Address - Phone:517-487-2225
Mailing Address - Fax:517-487-4474
Practice Address - Street 1:1914 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2829
Practice Address - Country:US
Practice Address - Phone:517-487-2225
Practice Address - Fax:517-487-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherCOMMERCIAL
MI=========OtherCOMMERCIAL