Provider Demographics
NPI:1386983237
Name:RUNBECK, CRAIG (NMD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:RUNBECK
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 S 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-1855
Mailing Address - Country:US
Mailing Address - Phone:602-237-9910
Mailing Address - Fax:
Practice Address - Street 1:7207 S 39TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-7200
Practice Address - Country:US
Practice Address - Phone:602-237-9910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ97-504175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath