Provider Demographics
NPI:1306854831
Name:RIFFEL, CRAIG E (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:E
Last Name:RIFFEL
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 1:36620 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-1134
Mailing Address - Country:US
Mailing Address - Phone:586-792-1800
Mailing Address - Fax:586-792-0612
Practice Address - Street 1:36620 GARFIELD RD
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48035-1134
Practice Address - Country:US
Practice Address - Phone:586-792-1800
Practice Address - Fax:586-792-0612
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIC0CRWOtherBILLING LOCATION CODE
MI95-0-E0-5317-0OtherBCBS PIN
MIU73008Medicare UPIN
MI95-0-E0-5317-0OtherBCBS PIN