Provider Demographics
NPI:1013373703
Name:CRAIG CHIROPRACTIC AND KINESIOLOGY PC
Entity Type:Organization
Organization Name:CRAIG CHIROPRACTIC AND KINESIOLOGY PC
Other - Org Name:WHOLE HEALTH FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-295-4301
Mailing Address - Street 1:611 WALNUT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-4575
Mailing Address - Country:US
Mailing Address - Phone:763-295-4301
Mailing Address - Fax:
Practice Address - Street 1:611 WALNUT ST STE 2
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-4575
Practice Address - Country:US
Practice Address - Phone:763-295-4301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty