Provider Demographics
NPI:1659581791
Name:OSWALD, CRAIG J (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:J
Last Name:OSWALD
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 1:13720 OLD SAINT AUGUSTINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-7414
Mailing Address - Country:US
Mailing Address - Phone:904-268-9100
Mailing Address - Fax:904-268-9700
Practice Address - Street 1:13720 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-7414
Practice Address - Country:US
Practice Address - Phone:904-268-9100
Practice Address - Fax:904-268-9700
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor