Provider Demographics
NPI:1194061713
Name:DAWSON, CRAIG RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:RICHARD
Last Name:DAWSON
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 1:11620 S STATE ST STE 1401
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-7124
Mailing Address - Country:US
Mailing Address - Phone:801-561-8000
Mailing Address - Fax:
Practice Address - Street 1:11620 S STATE ST STE 1401
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7124
Practice Address - Country:US
Practice Address - Phone:801-561-8000
Practice Address - Fax:801-567-3086
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-31
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4729461-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor