Provider Demographics
NPI:1750729950
Name:VERNON, CRAIG ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ROBERT
Last Name:VERNON
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 1:140 8TH ST SE
Mailing Address - Street 2:PO BOX 130
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1950
Mailing Address - Country:US
Mailing Address - Phone:515-957-9700
Mailing Address - Fax:515-957-9513
Practice Address - Street 1:140 8TH ST SE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1950
Practice Address - Country:US
Practice Address - Phone:515-957-9700
Practice Address - Fax:515-957-9513
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor