Provider Demographics
NPI:1063171130
Name:CRAFT, DAWN (DC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:CRAFT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 HIGH STREET #5B
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:54180-1158
Mailing Address - Country:US
Mailing Address - Phone:920-532-9071
Mailing Address - Fax:
Practice Address - Street 1:450 HIGH ST # 5B
Practice Address - Street 2:
Practice Address - City:WRIGHTSTOWN
Practice Address - State:WI
Practice Address - Zip Code:54180-1253
Practice Address - Country:US
Practice Address - Phone:920-532-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5707-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor