Provider Demographics
NPI:1043436330
Name:CRAGO FAMILY CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:CRAGO FAMILY CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-486-4772
Mailing Address - Street 1:4224 HOLLAND RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1900
Mailing Address - Country:US
Mailing Address - Phone:757-486-4772
Mailing Address - Fax:757-486-6511
Practice Address - Street 1:4224 HOLLAND RD
Practice Address - Street 2:SUITE 110
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1900
Practice Address - Country:US
Practice Address - Phone:757-486-4772
Practice Address - Fax:757-486-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06709Medicare ID - Type Unspecified