Provider Demographics
NPI:1881891794
Name:CANTRALL, CRAIG E (DPT)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:E
Last Name:CANTRALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1026 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-2612
Mailing Address - Country:US
Mailing Address - Phone:641-895-1650
Mailing Address - Fax:641-437-3522
Practice Address - Street 1:1 SAINT JOSEPH DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-9017
Practice Address - Country:US
Practice Address - Phone:641-437-3455
Practice Address - Fax:641-437-3522
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist