Provider Demographics
NPI:1245923812
Name:CRAIG, MADELINE ELIZABETH
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:ELIZABETH
Last Name:CRAIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 PROGRESS DR STE C
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3485
Mailing Address - Country:US
Mailing Address - Phone:563-551-4200
Mailing Address - Fax:563-345-4201
Practice Address - Street 1:4626 PROGRESS DR STE C
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3485
Practice Address - Country:US
Practice Address - Phone:563-551-4200
Practice Address - Fax:563-345-4201
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach