Provider Demographics
NPI:1982799425
Name:TARINI, CRAIG STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STEVEN
Last Name:TARINI
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 1:3420 MALL DR
Mailing Address - Street 2:STE 1
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-8147
Mailing Address - Country:US
Mailing Address - Phone:715-831-0955
Mailing Address - Fax:715-831-0949
Practice Address - Street 1:3519 GATEWAY DRIVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-8795
Practice Address - Country:US
Practice Address - Phone:715-831-0955
Practice Address - Fax:715-831-0949
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3591012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38911300Medicaid
WI38911300Medicaid
WI000135690Medicare ID - Type Unspecified