Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC005595L | PA |
NPI | 1013011188 |
---|---|
Provider Name | James Gregory Craine |
First Address | Sellersville, PA 18960 |
Second Address | North Wales, PA 19454 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 20/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01755389 | (05) | PA |
U71782 | (02) |