Provider Demographics
NPI:1770657355
Name:CRITES, HAROLD THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:THOMAS
Last Name:CRITES
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 1:785 W CORBETT AVE # B
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8453
Mailing Address - Country:US
Mailing Address - Phone:910-325-0834
Mailing Address - Fax:910-325-0833
Practice Address - Street 1:785 W CORBETT AVE # B
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-8453
Practice Address - Country:US
Practice Address - Phone:910-325-0834
Practice Address - Fax:910-325-0833
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC350047871OtherRAILROAD MEDICARE #
NC7908405Medicaid
CO84-0924462OtherTAX ID #
NC08405OtherBCBS #
NC08405OtherBCBS #
WYT44201Medicare UPIN