Provider Demographics
NPI:1760516975
Name:KRAFT, MARK AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:AARON
Last Name:KRAFT
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 1:32526 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
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor