Provider Demographics
NPI:1932321247
Name:CRAIG A BEUTTLER CHIROPRACTIC
Entity Type:Organization
Organization Name:CRAIG A BEUTTLER CHIROPRACTIC
Other - Org Name:FAMILY CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BEUTTLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FIAMA
Authorized Official - Phone:805-434-0888
Mailing Address - Street 1:225 POSADA LN STE C
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-4058
Mailing Address - Country:US
Mailing Address - Phone:805-434-0888
Mailing Address - Fax:805-434-0934
Practice Address - Street 1:225 POSADA LN STE C
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4058
Practice Address - Country:US
Practice Address - Phone:805-434-0888
Practice Address - Fax:805-434-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOR2639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18542Medicare ID - Type UnspecifiedMEDICARE GROUP ID