Provider Demographics
NPI:1346932290
Name:CRAIG, WENDY (ABOC, NCLEC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CRAIG
Suffix:
Gender:F
Credentials:ABOC, NCLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 E PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-6418
Mailing Address - Country:US
Mailing Address - Phone:719-578-0398
Mailing Address - Fax:
Practice Address - Street 1:3201 E PLATTE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6418
Practice Address - Country:US
Practice Address - Phone:719-578-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician