Provider Demographics
NPI:1063593366
Name:THE KRAFT CHIROPRACTIC CLINIC, INC.
Entity type:Organization
Organization Name:THE KRAFT CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-483-2225
Mailing Address - Street 1:2045 SAVIERS RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3651
Mailing Address - Country:US
Mailing Address - Phone:805-483-2225
Mailing Address - Fax:805-486-4646
Practice Address - Street 1:2045 SAVIERS RD
Practice Address - Street 2:SUITE 6
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3651
Practice Address - Country:US
Practice Address - Phone:805-483-2225
Practice Address - Fax:805-486-4646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 14671261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID NUMBER