Provider Demographics
NPI:1376648964
Name:CRAVEN CHIROPRACTIC, P.A.
Entity Type:Organization
Organization Name:CRAVEN CHIROPRACTIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:252-634-2447
Mailing Address - Street 1:3109 TRENT ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5736
Mailing Address - Country:US
Mailing Address - Phone:252-634-2447
Mailing Address - Fax:252-634-2448
Practice Address - Street 1:3109 TRENT ROAD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5736
Practice Address - Country:US
Practice Address - Phone:252-634-2447
Practice Address - Fax:252-634-2448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2937111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2339003OtherMEDICARE GROUP PRICING #