Provider Demographics
NPI:1639182934
Name:CATHEY, CRAIG B (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:B
Last Name:CATHEY
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 1:713 W ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4403
Mailing Address - Country:US
Mailing Address - Phone:575-622-0902
Mailing Address - Fax:575-622-1714
Practice Address - Street 1:713 W ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4403
Practice Address - Country:US
Practice Address - Phone:505-622-0902
Practice Address - Fax:505-622-1714
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM339407701Medicare ID - Type Unspecified
NMU90413Medicare UPIN