Provider Demographics
NPI:1740350602
Name:MAYER, CRAIG ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ADAM
Last Name:MAYER
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 1:1912 SOUTH UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-5849
Mailing Address - Country:US
Mailing Address - Phone:954-452-1000
Mailing Address - Fax:954-452-1609
Practice Address - Street 1:1912 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-5849
Practice Address - Country:US
Practice Address - Phone:954-452-1000
Practice Address - Fax:954-452-1609
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006160111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation