Petitgout, Craig Michael
Petitgout, Craig Michael is an sole proprietor health care provider with primary practice located at 850 22Nd Ave # 3 , Coralville IA 52241-1565. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Petitgout, Craig Michael can be contacted via phone (319) 354-9574.Contact Information
Primary practice address
850 22Nd Ave # 3
Coralville IA 52241-1565
Phone: (319) 354-9574
Fax: (319) 834-1128
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | A06076 | Iowa |
Profile Details
| NPI number | 1710911748 |
|---|---|
| LBN Legal business name | Petitgout, Craig Michael |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Nov 14th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710911748 | NPPES |
| Iowa | MEDICAID | 0160606 |
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