Provider Demographics
NPI:1659405876
Name:JAMES F. KRAFT DC PC
Entity Type:Organization
Organization Name:JAMES F. KRAFT DC PC
Other - Org Name:KRAFT CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-294-9100
Mailing Address - Street 1:32526 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-1454
Mailing Address - Country:US
Mailing Address - Phone:586-294-9100
Mailing Address - Fax:586-294-8378
Practice Address - Street 1:32526 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-1454
Practice Address - Country:US
Practice Address - Phone:586-294-9100
Practice Address - Fax:586-294-8378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P24570Medicare ID - Type Unspecified