Provider Demographics
NPI:1861684771
Name:SANFORD, CRAIG D (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:SANFORD
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 1:12801 DARBY BROOK CT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2497
Mailing Address - Country:US
Mailing Address - Phone:703-583-1222
Mailing Address - Fax:703-821-2480
Practice Address - Street 1:12801 DARBY BROOK CT 102
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2497
Practice Address - Country:US
Practice Address - Phone:703-583-1222
Practice Address - Fax:703-821-2480
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor