Provider Demographics
NPI:1629210786
Name:CRAFT, LAURIE BETH (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:BETH
Last Name:CRAFT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LAURIE
Other - Middle Name:BETH
Other - Last Name:HILLEBRENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:223 LANSING ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1605
Mailing Address - Country:US
Mailing Address - Phone:517-543-1115
Mailing Address - Fax:517-543-3290
Practice Address - Street 1:223 LANSING ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1605
Practice Address - Country:US
Practice Address - Phone:517-543-1115
Practice Address - Fax:517-543-3290
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor