Provider Demographics
NPI:1194876375
Name:VALARIK, CRAIG PAUL (DC)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:PAUL
Last Name:VALARIK
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 1:1100 S BROAD ST
Mailing Address - Street 2:#100A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-5024
Mailing Address - Country:US
Mailing Address - Phone:267-981-2843
Mailing Address - Fax:
Practice Address - Street 1:1129 PINE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6035
Practice Address - Country:US
Practice Address - Phone:215-922-6422
Practice Address - Fax:215-922-6425
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC - 002480 L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor