Provider Demographics
NPI:1235320672
Name:DR. STEVEN KRASKOW D.C., P.A.
Entity Type:Organization
Organization Name:DR. STEVEN KRASKOW D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KRASKOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:316-721-4494
Mailing Address - Street 1:2230 N CRESTLINE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1589
Mailing Address - Country:US
Mailing Address - Phone:316-721-4494
Mailing Address - Fax:
Practice Address - Street 1:5205 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1633
Practice Address - Country:US
Practice Address - Phone:316-684-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04533261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center