Provider Demographics
NPI:1023123411
Name:KRIVA, WILLIAM A (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:KRIVA
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 1:968 INWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-6625
Mailing Address - Country:US
Mailing Address - Phone:651-578-8588
Mailing Address - Fax:651-578-8587
Practice Address - Street 1:968 INWOOD AVE N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-6625
Practice Address - Country:US
Practice Address - Phone:651-578-8588
Practice Address - Fax:651-578-8587
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor