Provider Demographics
NPI:1376228122
Name:DECATUR AND CRAIG CHIROPRACTIC
Entity Type:Organization
Organization Name:DECATUR AND CRAIG CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-656-7460
Mailing Address - Street 1:4925 W CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2730
Mailing Address - Country:US
Mailing Address - Phone:702-656-7460
Mailing Address - Fax:702-656-7461
Practice Address - Street 1:4925 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2730
Practice Address - Country:US
Practice Address - Phone:702-656-7460
Practice Address - Fax:702-656-7461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty