Provider Demographics
NPI:1689813164
Name:CRAFT, DUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:
Last Name:CRAFT
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 1:3117 W RAPID ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2340
Mailing Address - Country:US
Mailing Address - Phone:605-341-9100
Mailing Address - Fax:605-341-9200
Practice Address - Street 1:3117 W RAPID ST
Practice Address - Street 2:SUITE 5
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2340
Practice Address - Country:US
Practice Address - Phone:605-341-9100
Practice Address - Fax:605-341-9200
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor