Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH3901 | FL |
N | 111NS0005X | Chiropractic Sports Physician | CH3901 | FL |
NPI | 1285643924 |
---|---|
Provider Name | Dr. Craig Alan Newman |
First Address | Tampa, FL 33609-2903 |
Second Address | Tampa, FL 33609-2903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55964 | (02) | FL |