Provider Demographics
NPI:1427180272
Name:BAUER, CRAIG IRA (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:IRA
Last Name:BAUER
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:PO BOX 50167
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33074-0167
Mailing Address - Country:US
Mailing Address - Phone:954-322-9798
Mailing Address - Fax:954-322-9787
Practice Address - Street 1:6067 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7947
Practice Address - Country:US
Practice Address - Phone:954-322-9798
Practice Address - Fax:954-322-9787
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor