Provider Demographics
NPI:1790103448
Name:RASCHKE, CRAIG LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:LYNN
Last Name:RASCHKE
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:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:WELLBORN
Mailing Address - State:TX
Mailing Address - Zip Code:77881-0133
Mailing Address - Country:US
Mailing Address - Phone:979-696-1996
Mailing Address - Fax:877-258-7732
Practice Address - Street 1:1605 ROCK PRAIRIE RD
Practice Address - Street 2:SUITE 318
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8358
Practice Address - Country:US
Practice Address - Phone:979-696-1996
Practice Address - Fax:877-258-7732
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor