Provider Demographics
NPI:1205104916
Name:STEVEN R KRAFT DC LLC
Entity type:Organization
Organization Name:STEVEN R KRAFT DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-337-3178
Mailing Address - Street 1:300 N FERRY ST
Mailing Address - Street 2:STE D
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1166
Mailing Address - Country:US
Mailing Address - Phone:586-337-3178
Mailing Address - Fax:
Practice Address - Street 1:300 N FERRY ST
Practice Address - Street 2:STE D
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-1166
Practice Address - Country:US
Practice Address - Phone:586-337-3178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007252111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty