Provider Demographics
NPI:1427050335
Name:CRAFT, DONNA L (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:L
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 1:332 N MAIN ST
Mailing Address - Street 2:PO BOX 130
Mailing Address - City:BROOKLYN
Mailing Address - State:MI
Mailing Address - Zip Code:49230-8609
Mailing Address - Country:US
Mailing Address - Phone:734-426-0902
Mailing Address - Fax:734-426-0903
Practice Address - Street 1:8110 JACKSON RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9132
Practice Address - Country:US
Practice Address - Phone:734-426-0902
Practice Address - Fax:734-426-0903
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950C85003OtherBCBS NUMBER
MI950C85003OtherBCBS NUMBER