Provider Demographics
NPI:1124193024
Name:BALDWIN, CRAIG ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALLEN
Last Name:BALDWIN
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 1:209 W MAIN ST
Mailing Address - Street 2:STE. B
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-2248
Mailing Address - Country:US
Mailing Address - Phone:316-755-9898
Mailing Address - Fax:316-755-9899
Practice Address - Street 1:209 W MAIN ST
Practice Address - Street 2:STE. B
Practice Address - City:VALLEY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67147-2248
Practice Address - Country:US
Practice Address - Phone:316-755-9898
Practice Address - Fax:316-755-9899
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor