Provider Demographics
NPI:1053510214
Name:CRAIG, SHAUN PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:PAUL
Last Name:CRAIG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 814
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-0814
Mailing Address - Country:US
Mailing Address - Phone:763-295-4301
Mailing Address - Fax:
Practice Address - Street 1:506 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8403
Practice Address - Country:US
Practice Address - Phone:763-295-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor