Provider Demographics
NPI:1184815573
Name:CRAIG ALAN DAVIS
Entity Type:Organization
Organization Name:CRAIG ALAN DAVIS
Other - Org Name:JOINT MANEUVERS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:928-855-1220
Mailing Address - Street 1:1850 MCCULLOCH BLVD N STE C5
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5798
Mailing Address - Country:US
Mailing Address - Phone:928-855-1220
Mailing Address - Fax:928-855-1221
Practice Address - Street 1:1850 MCCULLOCH BLVD N STE C5
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5798
Practice Address - Country:US
Practice Address - Phone:928-855-1220
Practice Address - Fax:928-855-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZWDCBBMedicare PIN