Provider Demographics
NPI:1780722579
Name:STICE, CRAIG MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:MARTIN
Last Name:STICE
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 1:13731 E RICE PLACE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015
Mailing Address - Country:US
Mailing Address - Phone:303-693-7922
Mailing Address - Fax:303-693-7849
Practice Address - Street 1:13731 E RICE PLACE
Practice Address - Street 2:SUITE 105
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015
Practice Address - Country:US
Practice Address - Phone:303-693-7922
Practice Address - Fax:303-693-7849
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4811111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor